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India - Second periodic reports of States parties due in 2000: Addendum [2003] UNCRCSPR 16; CRC/C/93/Add.5 (16 July 2003)

UNITED
NATIONS

CRC

G034386900.jpg

Convention on the
Rights of the Child

Distr.
GENERAL

CRC/C/93/Add.5
16 July 2003

Original: ENGLISH



COMMITTEE ON THE RIGHTS OF THE CHILD


CONSIDERATION OF REPORTS SUBMITTED BY STATES PARTIES
UNDER ARTICLE 44 OF THE CONVENTION


Second periodic reports of States parties due in 2000


INDIA *


[10 December 2001]


















* For the initial report submitted by the Government of India, see CRC/C/28/Add.10; for its consideration by the Committee, see documents CRC/C/SR.589-591 and CRC/C/15/Add.115.


GE.03-43869 (EXT)

CONTENTS

Pages


Introduction 4
Information Update 6
Action taken on Concluding Observations 15

Section

I. General Measures of Implementation (arts. 4, 42 and 44 para. 6) 23

II. Definition of the Child (art. 1) 63

III. General Principles 66
A. Best Interests of the Child (art. 3) 66
B. Non-Discrimination (art. 2) 70
C. The Right to Life, Survival and Development (art. 6) 80
D. Respect for the Views of the Child (art. 12) 87

IV. Civil Rights and Freedom (arts. 7, 8, 13-17 and 37(a)) 91
A. Name and Nationality (art. 7) 91
B. Preservation of Identity (art. 8) 95
C. Freedom of Expression (art. 13) 96
D. Freedom of Conscience, Thought and Religion (art. 14) 97
E. Freedom of Association and Peaceful Assembly (art. 15) 98
F. Protection of Privacy (art. 16) 99
G. Access to Appropriate Information (art. 17) 100

H. The Right Not to be Subjected to Torture or Other Cruel, Inhuman or Degrading Treatment and Punishment (art. 37(a)) 103

V. Family Environment and Alternate Care (arts. 5, 18, paras. 1-2, 9-11,. 19-21,
25, 27, para. 4, and 39) 105
A. Parental Guidance (art. 5) 105
B. Parental Responsibility (art. 18) 108
C. Separation from Parents (art. 9) 112
D. Family Reunification (art. 10) 113
E. Illicit Transfer and Non-Return (art. 11) 114
F. Recovery of Maintenance for the Child (art. 27) 115
G. Children Deprived of their Family Environment (art. 20) 117
H. Adoption (art. 21) 119
I. Periodic Review of Placement (art. 25) 126

J. Abuse and Neglect (art. 19), including Physical and Psychological
Recovery and Social Reintegration (art. 39) 128

VI. Basic Health and Welfare (arts. 6, 18, para. 3, 23, 24, 26, 27 para. 1-3) 132
A. Health and Health Services (art. 24) 132
B. Disabled Children (art. 23) 201

Page

Section

C. Social Security and Childcare Services and Facilities (art. 26
and 18, para. 3)262 217
D. Standard of Living (art. 27) 222

VII. Education, Leisure and Cultural Activities (arts. 28, 29, 31) 232
A. Education, including Vocational Training and Guidance (art. 28) 232
B. Aims of Education (art. 29) 296
C. Leisure, Recreation and Cultural Activities (art. 31) 305

VIII. Special Protection Measures (arts. 22, 38, 39, 40, 37(b)-(d), 32-36) 315
A. Children in Situation of Emergency 315
1. Refugee Children (art. 22) 315

2. Children in Armed Conflicts (art. 38), including Physical and Psychological Recovery and Reintegration (art. 39) 323
B. Children involved with the System of Administration of Juvenile Justice 324
1. The Administration of Juvenile Justice (art. 40) 324

2. Children Deprived of their Liberty, including any Form of
Detention, Imprisonment or Placement in Custodial Settings
(art. 37 (b)-(d)) 341

3. The Sentencing of Children, with Particular Reference to the
Prohibition of Capital Punishment and Life Imprisonment
(art. 37 (a)) 345

4. Physical and Psychological Recovery and Social Reintegration
of the Child (art. 39) 346

C. Children in Situation of Exploitation, including Physical and
Psychological Recovery and Social Integration 350

1. Economic Exploitation of Children, including Child Labour
(art. 32) 350
2. Drug Abuse (art. 33) 368

3. Sexual Exploitation and Abuse (art. 34) 375
4. Sale, Trafficking and Abduction (art. 35) 375
5. Other Forms of Exploitation (art. 36) 385
D. Children belonging to a Minority or an Indigenous Group (art. 30) 389

IX. Looking Ahead 411

Bibliography 413
Abbreviations 421
Endnotes 424

INTRODUCTION

1. India, the Union of 28 States and seven Union Territories is a socialist, secular and democratic republic. The Indian Constitution envisages a parliamentary form of government and is federal in nature with some unitary features. The states of India vary greatly in terms of language, culture and human development. The size and population of some of India’s largest states is comparable to some countries in Europe, Africa, Latin America or Asia. India today stands at the threshold of great change and opportunity. It is self-sufficient in agricultural production, its economy is poised for rapid growth, and it is one of the most industrialized countries in the world. India’s strong presence in the information technology sector is acknowledged by the world.

2. India continues to wage its battle against poverty, and its attendant negative ramifications, such as a high mortality rates, malnutrition and illiteracy, the greatest victims of which are children and women. India has 400 million children below the age of eighteen years, the largest child population in the world. India considers it a matter of utmost priority that its children grow and develop in health and happiness, receive education and develop skills, so that they can realize their complete potential and effectively participate and contribute to the social, cultural and economic life of our nation.

3. This First Periodic Report on the Convention of the Rights of Child (CRC) is the result of a detailed exercise that extended for more than a year. We have tried to make the report as participatory and comprehensive as possible, and have solicited inputs through questionnaires from related ministries, from state governments, non-governmental organizations (NGOs) and experts, from citizens and children. Questionnaires were posted on our web site and the public was requested to offer their comments and views through newspaper advertisements. The support of the United Nations Children’s Fund (UNICEF) in the preparation of this report is gratefully acknowledged.

4. It has been our intention to make the report as broad-based and representative as possible. Hence, the report details not only government legislation, programmes and data, but also quotes from reports and data from several non-governmental sources, such as from independent research studies by NGOs and experts, and from international organizations, even though the intellectual rigour, accuracy or precision of such data has not been endorsed or authenticated.

5. This report combines an analysis of the overall implementation of CRC in our country, a review of its progress, and identification of continuing challenges that impede the effective implementation of children’s rights. We recognize that the position of women in society, their health, access to education and information enhances their ability to improve not only their lives but also the lives of their children and families. Children’s rights, especially those of girl children, are irrevocably linked to women’s empowerment. It has been demonstrated universally that investment in girl’s education brings about high social and economic returns. India has taken bold and substantial initiatives in the area of women’s empowerment. To highlight the centrality of women’s empowerment to healthy child development as also to development in general, the year 2001 was celebrated as the “Women’s Empowerment Year’, with special focus on the girl child and adolescent girls.

6. We are fully committed to universalization of elementary education, by not only making it a fundamental right of all our children, but also as a key strategy to address the problems arising from poverty. The Sarva Shiksha Abhiyaan (SSA) launched by the government of India in November 2000, is a major step towards this direction. The Constitutional 93rd Amendment Bill 2001, passed recently by Parliament, will make education of all children in the age group of 614 years a fundamental right. The Bill also aims to include early childhood care and education to all children up to the age of six years as a directive principle of state policy of our Constitution.

7. We also hope to establish the National Commission for Children shortly, which will act as a vigilant guardian and protector of children’s rights in India. We are deeply concerned about the growing menace of child trafficking. India signed the “SAARC Convention on Prevention and Combating Trafficking in Women and Children for Prostitution”, on 5 January 2002 and we believe that cross-country trafficking can be addressed effectively through its operationalization. The Government of India has also initiated a new scheme called Swadhar for providing relief and rehabilitation for women in difficult situations that includes women and child victims of trafficking.

8. Realization of children’s rights certainly requires large resources. However, the key element in this effort is the “will of the community”. We have to mobilize the nation fully, strengthen and accelerate ongoing programmes and undertake new initiatives in gap areas, so that all our children can enjoy their rights to survival, protection, growth and development. The magnitude of our challenge is immense. With full partnership with the community and non-governmental sectors, we rededicate ourselves towards this end.


Dr. R.V. Valdyanatha Ayyar
Secretary
Department of Women and Child Development
Ministry of Human Resource Development
Government of India
New Delhi-110 001

INFORMATION UPDATE

9. This Periodic Report was planned for submission to the United Nations Committee on the Rights of the Child in 2001. Internal discussion among ministries, constant feedback on the report and availability of new data have been a continuing challenge in the task of finalizing the Report. In order to incorporate new developments, information and feedback, this additional chapter “Information Update” has been added to the report.

Elementary Education as a Fundamental Right

Thematic Area: Education, Leisure and Cultural Activities [arts. 28, 29, 31]

10. The Directive Principle under article 45 of the Constitution of India, lays down that the States within a period of ten years of commencement of the Constitution will provide free and compulsory education to all children until they complete 14 years of age.

11. The Government of India is completely committed to Universalization of Elementary Education. In 1997, the 83rd Amendment Bill was introduced in Parliament to make education a fundamental right of all children between 6-14 years.

12. Subsequently, the Bill was referred to the Parliament Standing Committee on Human Resource Development. Based on the recommendation of the Parliamentary Standing Committee, advice of the Ministry of Law and suggestions of the Law Commission, the Ministry of Human Resource Development formulated the revised Constitution Amendment Bill. This Bill known as the 93rd Constitution Amendment Bill has been passed by both houses of Parliament and is awaiting Presidential assent[1] .

13. The provisions laid down in the 93rd Amendment Bill are as follows:

14. Recognizing the importance of Early Childhood Care and Education, the 93rd Amendment has included an explicit provision in article 45 of the Constitution under which the State shall endeavour to provide Early Childhood Care and Education to all children in the age group 0-6 years.[2]

15. The Sarva Shiksha Abhiyan (SSA) launched by the Government of India is the vehicle for implementing the Constitutional obligation under the 93rd Amendment Bill.[3]

Education for All

Thematic Area: Education, Leisure and Cultural Activities [arts. 28, 29, 31]

16. The Sarva Shiksha Abhiyan is an effort to recognize the need for improving the performance of the school system and to provide community-owned quality elementary education in the mission mode. It also envisages bridging of gender and social gaps. The objectives of SSA are:

  1. All children in the age group 6-14 years in school/Education Guarantee Scheme centre/Bridge Course by 2003;
  2. All children in the age group 6-14 years complete five years of primary schooling by 2007;
  3. Focus on elementary education of satisfactory quality with emphasis on education for life;
  4. Bridge all gender and social category gaps at primary stage by 2007 and at elementary education level by 2010;
  5. Universal retention by 2010.

17. The approach of SSA is community-owned. Village education plans prepared in consultation with Panchayati Raj Institutions will form the basic elementary education plans. The SSA will cover the entire country by 2002[4] with a special focus on educational needs of girls, scheduled castes and scheduled tribes and other children in difficult circumstances.

18. Some of the major initiatives taken under the SSA are:

  1. Free textbooks are given to all girls, and there is a provision of innovative intervention for girls to the tune of Rs. 5 million per districts. Also 50 per cent of teachers selected now have to be women.[5]
  2. Under SSA, a no rejection policy is being followed and there is a provision of
    Rs 1200 per child for interventions for IED.[6]

19. The Non-Formal Education (NFE) Scheme was revised under the name “Education Guarantee Scheme and Alternative and Innovative Education “(EGS & AIE) in 2000 to improve access in education, with flexibility to cater to diverse needs of out of school children. The new scheme guarantees opening of Education Guarantee scheme schools in unreserved habitations where there are no schools within a radius of 1 km. EGS & AIE supports diversified strategies for out of school children including bridge courses, back to school camps, seasonable hostels, summer camps, mobile teachers and remedial coaching.[7]

20. The Ministry of Human Resource Development has set up a National Level Mission under the Chairmanship of the Prime Minister.

21. The Ministry has released grants to the States/ Union Territories for starting preparatory activities in 24 non-DPEP districts and for upper primary in 59 DPEP Phase-I districts.

22. For implementing SSA, it is estimated that an amount of Rs 98,000 crores would be required over a period of ten years till 2010.[8]

23. The PAB has also approved the District Elementary Education Plans (DEEPs) of 512 districts (253 DPEP Districts and 259 non-DPEP districts) and an outlay of Rs 1106.26 crores.

24. All DPEP districts have been identified for vertical expansion of primary education towards upper primary, covering the entire elementary education stage.[9] The DPEP programme which was initially launched in 1994 in 42 districts of seven States, has now been extended to cover 271 districts of 18 States, namely, Assam, Haryana, Karnataka, Kerala, Maharashtra, Tamil Nadu, Madhya Pradesh, Gujarat, Himachal Pradesh, Orissa, Andhra Pradesh, West Bengal, Uttar Pradesh, Rajasthan, Chhattisgarh, Jharkhand and Uttaranchal.[10]

25. The Government of India, for the year 2000-2001, has increased the investment in education to 3.91 per cent of GDP.[11]
26. The Seventh All India Educational Survey is now being launched by the Government of India.[12]

27. Paras. 25, 26, 27 of page 246 stand deleted since census 2001 figures are available.[13]

Adoption

Thematic Area: Family Environment and Alternate Care [arts. 5, 18, paras. 1-2, 9-11,
19-21, 25, 27, paras. 4 and 39]

28. In order to ensure the Best Interests of the Child, as per article 21 of the Convention on Rights of the Child, revised Guidelines for Adoption of India Children (1995) have been issued by the Ministry of Social Justice and Empowerment, Government of India.

29. The Central Adoption Resource Agency (CARA), an autonomous body of the ministry is responsible for implementing these Guidelines and it works as a clearing house of all information on all matters concerning inter country adoption.[14] Certain other agencies like the Juvenile Welfare Board (JWB) and Scrutiny Agencies are also involved in the process of adoption. The JWB declares an abandoned child as legally free for adoption. The Scrutiny Agency is asked by the Court to scrutinize application of the adoptive parents before an adoption/guardianship order is issued.[15]

30. The main objective of CARA is to promote in-country adoption and regulate inter country adoption. In this regard, circulars are issued by CARA to the adoption agencies and State Governments from time to time, for carrying out adoption as per the directives of the Supreme Court of India.[16] CARA recognises Indian adoption agencies for inter country adoptions. It also recognizes Voluntary Co-ordinating Agencies, which promote in-country adoption. The recognition is granted on the basis of recommendation of the concerned State Governments.[17] The number of recognized National agencies for inter-country adoption is now 73. Similarly, 248 foreign agencies have been enlisted in more than 30 countries to sponsor inter country adoption of Indian children.[18]

40. It is encouraging to note that the number of adoptions has been increasing every year and for the year 2001 the figures are as follows2 :

In-country Adoption 1 899

Inter country Adoption 1 298

Total 3 197

Thus, the total number of adoptions that have taken place since 1995 to 2001 is as follows:[19]

In-country Adoptions 11 450

Inter country Adoptions 8 613

Total 20 063

41. CARA has undertaken a number of initiatives to make all adoptions transparent and legal. In this regard, circulars have been issued to the State Governments to arrest the trend of private nursing homes and children placed directly from nursing homes/hospital. Through the publicity and awareness programmes of CARA and its recognized agencies, the public at large are advised to avoid any secret or private adoption and, instead, to go for legal adoption.[20]

42. In addition to the above, India intends to sign and ratify the Hague Convention.3

Infant Mortality Rate

Thematic Area: Basic Health and Welfare [arts. 6, 18 para. 3, 23, 24, 26, 27, paras. 1-3]

43. The Ministry of Health and Family Welfare, Government of India is implementing several programmes for reduction of infant and child mortality. These initiatives have helped in bringing down the IMR from 70 to 68.[21] For more details please see table 1.

44. The Rajnandgaon district is presently in Chhattisgarh. The State Government has taken remedial measures through alternate water supply schemes to the affected in Rajnandgaon district.[22]

Crime against Children

Thematic Area: Special Protection Measures [arts. 22, 38, 39, 40, 37 (B)-(D), 32-36]

45. The “Childline Service”iv started first in Mumbai is now available in 38 cities—Ahmedabad, Allahabad, Alwar, Baroda, Bhopal, Bhubaneswar, Calicut, Chandigarh, Chennai, Cochin, Coimbatore, Cuttack, Delhi, Goa, Guwahati, Hyderabad, Indore, Jaipur, Kalyan, Kolkata, Kutch, Lucknow, Mangalore, Madurai, Mumbai, Nagpur, Patna, Pune, Puri, Ranchi, Salem, Shillong, Thiruvananthapuram, Tiruchirapalli, Udaipur, Varanasi, Vijaywada, Visakhapatnam. It is aimed to cover 60 more cities by the end of financial year 2002-03.[23]

46. The National Institute of Social Defence, is an autonomous body under the Ministry of Social Justice and Empowerment, Government of India.[24]

Table 1: Infant Mortality Rate
State/UT
IMR (in unit s)
State/UT
IMR (in units)
1999*
2000**
1999*
2000**
Andhra Pradesh
66
65
Nagaland
NA
NA
Arunachat Pradesh
43
44
Orissa
97
96
Assam
76
75
Pondicherry
22
23
Bihar
63
62
Punjab
53
52
Chhattisigarh
78
79
Rajasathan
81
79
Delhi
31
32
Sikkim
49
49
Goa
21
23
Tamil Nadu
52
51
Gujarat
63
62
Tripura
42
41
Haryana
68
67
Uttar Pradesh
84
83
Himachal Pradesh
62
60
Uttaranchal
52
50
Jammu and Kashmir
NA
50
West Bengal
52
51
Jharkhand
71
70
Andaman and Nicobar Islands
25
23
Karnataka
58
57
Chandigarh
28
28
Kerala
14
14
Dadra and Nagar Haveli
56
58
Madhya Pradesh
90
88
Daman and Diu
35
48
Maharashtra
48
48
Lakshadweep
32
27
Manipur
25
23
India
70
68
Meghalaya
56
58



Mizoram
19
21



Source: * SRS Bulletin (Vol. 35 No.1), April 2001, Registrar General, Inida
** SRS Bulletin (Vol. 35 No. 2), October 2001, Registrar General, India

Juvenile Delinquency

Thematic Area: Special Protection Measures [arts. 22, 38, 39, 40, 37 (B)-(D), 32-36]

47. The National Crime Records Bureau (N C R B), Ministry of Home Affairs, Government of India, has recently published the Crime in India, 2000. The latest data are given under table 23.[25]

48. The Juvenile Justice (Care and Protection of Children) Bill, 2000 has been passed by both Houses of Parliament and has now become an Act of Parliament—The Juvenile Justice (Care and Protection of Children) Act, 2000.

Table 2: Juvenile Apprehended Under IPC and SLL Crimes by Age Group—1999-2000
Year
7-12 Years
12-16 Years
16-18 Years
Total

No
%
No
%
No
%

1999
4039
21.9
10311
55.9
4110
22.3
18460
2000
3292
18.3
11389
63.3
3301
18.4
17982

Source: Crime in India—2000, N C R B, Ministry of Home Affairs, Government of India


Table 3: Juvenile Delinquency (SLL) Under Different Crime Heads
and Percentage Variation in 2000 over 1999
Crime Head
Number of Cases Reported During
Percentage Change in 2000 over 1999
1999
2000

Gambling Act
113
131
15.9
75
113
50.7
Prohibition Act
733
519
-29.2
Immoral Traffic (P) Act
75
82
9.3
Indian Railways Act
105
78
-25.7
SC/ST (Prevention of Atrocities) Act
18
25
38.9

Source: Crime in India—2000, N C R B, Ministry of Home Affairs, Government of India

National Child Labour Projects

Thematic Area: Special Protection Measures [arts. 22, 38, 39, 40, 37 (B)-(D), 32-36]

49. The National Child Labour Projects, started by the GOI with the aim of withdrawing children from hazardous employment and ensuring their rehabilitation through education in special schools, has sanctioned 100 Child Labour Projects for rehabilitating nearly 0.21 million children in the most endemic areas and 1,89,615 have already been enrolled in the special schools.6 For more details please see table 4 .

Table 4: Coverage under National Child Labour Projects[26]
State
Sanctioned No. of
Actual Coverage
Schools
Children
Schools
Children
Andhra Pradesh (22)*
975
61050
999
65541
Bihar (8)
194
12200
194
12016
Karnataka (5)
190
9500
105
5222
Madhya Pradesh (8)
237
14500
140
7408
Maharashtra (2)
74
3700
61
3184
Orissa (18)
696
39550
628
34932
Rajasthan (6)
180
9000
136
6800
Tamil Nadu (9)
425
21900
414
20654
Uttar Pradesh (11)
370
22500
307
18567
West Bengal (8)
346
17350
279
13941
Punjab (3)
107
5350
27
1350
Grand Total (100)
3794
216600
3290
189615

*Figures in brackets indicate Districts.
Source: D.O. No S-27022/1/97-CL dated March 7, 2002, Ministry of Labour, Government of India

50. The Government is also considering ratification of ILO Convention 182.[27]

Trafficking of Children for Commercial Sexual Exploitation

Thematic Area: Special Protection Measures [arts. 22, 38, 39, 40, 37 (B)-(D), 32-36]

51. India signed the SAARC Convention on Preventing and Combating Trafficking in Women and Children for Prostitution on 5 January 2002. As a signatory, India has committed itself to cooperation with member States in order to implement the Convention.

52. The Government of India has, in December 2001, launched a scheme called Swadhar for recovery and reintegration of trafficked victims. The scheme is meant for women in difficult circumstances, including women and children rescued from trafficking. It provides the funds for the immediate shelter of rescued victims, counselling, social and economic rehabilitation through education and skill upgradation, medical and legal support. This holistic programme is implemented in partnership with NGOs.

53. To combat the trafficking of women and children for commercial sexual exploitation, the Department of Women and Child Development has formulated Grant in Aid Schemes addressing the issue of trafficking, with specific need-based focus on prevention at source areas and rescue and rehabilitation at destination areas. The project for prevention at source areas emphasizes the empowerment of the girl child and women through awareness generation, education and vocational training, poverty alleviation, microcredit schemes through women’s groups and self-help groups and the involvement of Panchayats, the grass-roots democratic institutions. In destination areas, the emphasis is on rescue and rehabilitation. These schemes are implemented in partnership with the NGOs.

54. The response to the Swadhar and Grant in Aid schemes has been very positive. So far 11 projects catering to the needs of 565 rescued women at a total of over Rs 2 crores have been sanctioned. Projects to the tune of Rs 15 crores are under process at various stages for sanction.

______________________________________________________________________________

The preparation of this report has been guided by the participation and information supplied from related ministries of the GOI, from State Governments, NGOs and experts, from citizens and children. Other than from governmental sources, data from a vast array of non-governmental sources and from international organizations, have been incorporated, so as to make the Report as comprehensive and broad based as possible. However, these inclusions should not be understood as authentication of same.

ACTION TAKEN ON THE CONCLUDING OBSERVATIONS OF THE

UNITED NATIONS COMMITTEE ON CHILD RIGHTS

55. India submitted its Initial Report on the implementation of the CRC in 1997. This was reviewed by the United Nations Committee on Child Rights in January, 2000. Below are defined key initiatives being undertaken by various Departments of the Government of India (GOI), which address some of the observations and recommendations of the Committee.

A. General measures of implementation

Legislation

56. GOI is in the process of undertaking a comprehensive review of the legislation concerning children. This will also be done by the National Commission for Children which will be established very shortly. Meanwhile, various processes to review and amend laws concerning children are under way. Some of the amendments that have already been made are as follows:

(a) The Juvenile Justice Act has been repealed and replaced by a new legislation called the Juvenile Justice (Care and Protection of Children) Bill, 2000;
(b) The Cable Television Network Rule has been amended. For more details refer to the section on General Measures of Implementation;
(c) A National Commission for Children (NCC) for protecting the rights of children is on the anvil. The NCC will have statutory powers to inquire into violations of child rights. It shall review all the laws pertaining to children and make recommendations in order to harmonise them with the provisions of the CRC;
(d) The Law Commission has reviewed the Code of Criminal Procedure and is likely to undertake a comprehensive review of the Indian Penal Code and the Indian Evidence Act;
(e) Other measures being contemplated include an amendment to the Infant Milk Substitutes. Feeding Bottle and Infant Foods (Regulation of Production, Supply and Distribution) Act, 1992 to strengthen its provisions to promote breastfeeding;
(f) Government have initiated the process for ratification of Convention No. 182 on the Worst Forms of Child Labour and to specify the minimum age for admission to employment and work. The above have been dealt in detail under relevant sections of the Report.

57. The Government has taken all measures to implement the orders issued by the Courts in India. (For details please refer to pages 5-8 in the section on General Measures of Implementation.)

Coordination

58. The National Plan of Action for Children, 1992 was developed after the World Summit. Its progress has been assessed. However, this will be reviewed and modified keeping the child Rights approach in mind. (For more details, please see pages 8-9 of the section on General Measures of Implementation.)

59. With the objective of strengthening co-ordination at the GOI level, a National Co-ordination Mechanism was constituted by DWCD for monitoring the implementation of the CRC. (For details please refer to page 11 of the section on General Measures of Implementation.) Training for different categories of people is being carried out by the Government. However, there is a need for systematic capacity building of local authorities. (For details please refer to pages 21-25 of the section on General Measures of Implementation.)

Independent/Monitoring Structures

60. India has a very well-developed statistical system and it is one that the country is justifiably proud of. The office of the Registrar General of India, the National Sample Survey Organization, the International Institute of Population Sciences and other organizations conduct regular surveys on a large set of child indicators and report trends at the National, state and district levels. (For details please refer pages 13-16 of the section on General Measures of Implementation of this Report.)

61. Status of disaggregated data of all persons under 18 years of age by State, sex, rural/urban, SC/ST is available for literacy rate, school enrolment, sex ratio, IMR (0-1), IMR (0-5), malnutrition, disabilities, child labour and partially available for street children, refugee children and children affected by terrorism and insurgency. However, data collection needs to be strengthened on all issues under the CRC.

62. A National Commission for Children (NCC) for protecting the rights of children is on the anvil. The NCC will have statutory powers to inquire into violations of child rights. (For details please refer page 7 of the section on General Measures of Implementation of this Report.)

Allocation of Budgetary Resources

63. While utmost priority is given to children in policymaking, the budgetary allocations are sometimes less than desirable. There is a need for advocating greater resource allocation for children and analysis of the impact of budgets and new policy decisions. (For details please refer page 36 of the section on General Measures of Implementation.)

Cooperation with NGOs

64. While one observes an increased participation by several stakeholders in the dissemination and discussion on child rights at national and decentralised levels, it is evident that these need to be more comprehensive. It is becoming clear that a systematic plan for spreading awareness among different groups, mobilising action and dialogue within civil society on child rights is necessary and would need to become a key area for the National Co-ordination Mechanism on CRC implementation to monitor. (For details please refer to page 17 of the section on General Measures of Implementation of this Report.)

65. During the preparation of the Second Country Report, NGOs were involved at the regional and state levels to give their inputs. The Planning Commission is in the process of preparing strategy papers for the 10th Five-Year Plan. NGOs have been co-opted to give their views for preparation of the strategy papers.

Training/Dissemination of the Convention

66. The size and complexity of India and the structure of the GOI makes it difficult to capture and define a national overview of the capacity development initiatives that have been put in place for accelerating the implementation of CRC. Training for different categories of people have evolved in response to the need to sensitise programme staff on child rights. The NGOs, staff or organisations working with child labour, inspectors, police officials and children themselves have been key targets for CRC training programmes. This has to percolate to the level of field functionaries of different programmes, parents and community members. It is necessary to undertake a comprehensive review of training efforts on child rights in different parts of the country and develop a systematic capacity development strategy for progressive implementation of child rights. (For more details please refer to pages 21-23 of the section on General Measures of Implementation of this Report.)

B. Definition of the Child

67. Minimum Legal Age has been defined for issues such as marriage, sexual consent for girls, voluntary enlistment in the armed forces, admission to employment or work, criminal responsibility, juvenile crime, capital punishment and life imprisonment.

68. In the Juvenile Justice (Care and Protection of Children) Act, 2000 the definition of the boy child has been increased to 18 years (in consonance with the girl child). Boys up to 18 years will be kept in the special homes only and will not go to jail. (For more details refer to page 43-46 of the section definition of the child.)

C. General Principles

The Right to Non-Discrimination

69. As a first step in the process of instituting social justice, two exclusive Ministries, i.e., the Ministry of Social Justice and Empowerment for SCs, OBCs and Minorities in 1998 and the Ministry of Tribal Affairs in 1999 have been set up to extend focused attention to these individual groups. Special efforts to safeguard interests of disadvantaged groups needs to be taken up on a priority basis. Although, voluntary organizations/NGOs have been playing a vital role in assisting Government in reaching rural and far flung tribal areas, they are uneven, in their distribution and are urban oriented. Therefore, all grant-in-aid schemes for NGOs have been recently reviewed and it has been suggested to enlarge the scope and coverage. The pace of progress of expenditure in the Backward Classes Welfare Sector appears to be satisfactory. However, a qualitative assessment of the progress will be made to assess improvement in the status of these socially disadvantaged groups.

70. To ensure effective enforcement of the Protection of Civil Rights Act, 1955 and Scheduled Castes and Scheduled Tribes (Prevention of Atrocities) Act, 1989, a definite plan of action ensuring preventive, investigative and rehabilitative measures are being taken in those areas/districts where incidence of crimes/atrocities/violence is high against the weaker sections. Another measure to ensure social justice was the commitment on the part of the government for a complete removal of the inhuman practice of manual scavenging by the year 2002 through a nation wide scavengers scheme of liberation and rehabilitation of scavengers and their dependants. As the progress of this scheme is very tardy, steps are being taken to activate the States/Uts to fulfil the commitment.

71. The Government has taken several initiatives to prevent discrimination of the girl child. One of the initiatives is that of Meena. The Meena series present positive images of girls, succeeding in making a strong case for receiving equal and fair treatment. Meena episodes have their basis in the CRC and the CEDAW. Some of the issues covered by Meena are girls education, equal opportunity for girls, health, dowry, sanitation and hygiene, and early marriage. (For more details please refer to pages 54-64 of the section on Non-Discrimination of this Report.)

Respect for the Views of the Child

72. It is indeed welcome that there is a gradual increase in the initiatives to promote child participation in many parts of the country. The initiatives vary in content and comprehensiveness from participation in activities, to expression of views in matters that affect their lives as well as that of other in many parts of the country. As one examines the implementation of this aspect of the Convention, it is evident that progress have been made in this area through the active intervention of NGOs. Some of the States such as Rajasthan and Uttar Pradesh have taken a lead in this regard. It is time that other States/Uts follow their example. Training of teachers, social workers and local officials is being carried out for implementation of such programmes. This issue is evolving rapidly. (For details please refer to pages 72-76 of the section on Respect for the views of the Child of this Report.)

D. Civil Rights and Freedom

Name and Nationality

73. The Office of the Registrar General of India is undertaking several measures to improve the Civil Registration System (CRS). Newspaper advertisements, televisions spots, radio jingles, posters, stickers and cinema slides are some of the measures currently being used to sensitise and mobilise public opinion on the need and importance of birth registration. Training and workshops are being organised for registry personnel. (Details of these measures have been dealt with on pages 81-84 of the section on Names and Nationality of this Report.)

Right not to be Subjected to Torture or Other Degrading Treatment or Punishment

74. The new legislation called Juvenile Justice (Care and Protection of Children) Act, 2000 prohibits any kind of torture or other cruel, inhuman or degrading treatment or punishment juveniles. (For details please refer to page 94 of the Section on Right not to be Subjected to Torture or Other Cruel, Inhuman or Degrading Treatment or Punishment.)

E. Family Environment and Alternate Care

Adoption

75. India is not a party to the Hague Convention. However, the country already has an institutional mechanism envisaged under the Convention, i.e. Central Adoption and Resource Agency (CARA) which has been constituted to act as a clearing house of information regarding children available for inter-country adoption. It also acts as a nodal agency for receiving applications from prospective parents and forwarding them to recognized child welfare agencies (For details please refer to pages 120-124 of the section on Adoption.)

Violence/Abuse/Neglect/Maltreatment

76. Corporal punishment in families is usually not reported, as the family in India is a private Institution. There is no national legislation against corporal punishment. However, a number of States, Delhi being one of them, have enacted legislation banning corporal punishment in schools. The GOI has also issued instructions to the States to prevent corporal punishment in schools. (For details, please refer to page 127 of the section on Abuse and Neglect including Physical and Psychological Recovery and Social Reintegration of this Report.)

F. Basic Health and Welfare

Disabled Children

77. The GOI is taking several measures to effectively implement the provisions of the Persons with Disabilities (Equal Opportunities, Protection of Rights and Full Participation) Act, 1995. Awareness campaigns and training programmes for persons working with disabled children is an ongoing programme of the Ministry of Social Justice and Empowerment. However, only an estimated five-percent of population with disabilities has been reached by any kind of service.i Even voluntary effort is largely confined to urban and semi-urban areas. (For details please refer to pages 203-209 of the section on disabled children.)

78. India does not have Integrated Management of Child Illness Strategy. However, the RCH Programme has integrated many of the issues laid out in the strategy. One of them is to extend maximum coverage by improving accessibility, especially for women, adolescents, socio-economically backward groups, tribals and slum dwellers, with a view to promote equality. (For more details please refer to pages 135-136 of the section on health and Health Services.) The GOI has undertaken studies to determine the socio cultural factors which lead to practices such as female infanticide and selective abortions.

79. The GOI has already taken steps to strengthen the existing Reproductive and Child Health Programmes. This programme integrates all family welfare and women and child health services with the explicit objective of providing beneficiaries with need-based, client-centred, demand-driven, high-quality, integrated RCH services. A comprehensive Draft National AIDS Prevention and Control Policy has been formulated, on various issues related to the prevention and control of HIV/AIDS in the country. The IEC Strategic Plan for AIDS prevention and Control Programme in India includes a variety of communication strategies for raising awareness, behavioural change and social mobilisation. The area of focus includes Family Awareness Campaigns and Prevention and Treatment of STD/RTI, Campaigns for Youth, School AIDS Programme, Women, Stigma and Discrimination, Voluntary Blood Donations and Advocacy. (For details please refer to pages 135-188 of the section on Health and Health Services.)

Right to Adequate Standard of Living

80. The GOI is implementing an Integrated Programme for Street Children and also a Programme for Juvenile Justice. These Programmes look into the needs of children who are victims of physical, sexual and substance abuse. (For details please refer to pages 364-365 of the section on Physical and Psychological Recovery and Social Reintegration of the Child.)

G. Education, Leisure and Cultural Activities

Rights and Aims of Education

81. The 83rd Amendment Bill of the Constitution of India is under consideration in the Parliament. A comprehensive review of the education situation was taken in November 1999 by the Department of Education. One of the steps to be identified in the review was to enact legislation for providing free and compulsory elementary education to all children in the age group of 6-14 years. (For details please refer to pages 244-245 of the section on Education, including vocational training and guidance.)

82. The Government has taken considerable measures to address disparities in access to education. Education of the girl child. Special Educational Development Programmes for Scheduled Caste girls. Non Formal Education, Education for the SCs/STs and Minorities, Children with Special Needs are some of the initiatives taken in this regard. (For details please refer to pages 294-302 of the section on Education, including vocational training and guidance.)

83. The performance of the NFE scheme has been reviewed and also has been evaluated by the Planning Commission. Based on their recommendation, action has been taken to revise the scheme and call it the Scheme for Alternate and Innovative Education. One of the salient features of the scheme would be to ensure quality of NFE. (For details please refer to pages 299-301 of the section on Education, including vocational training and guidance.)

84. The concept of value orientation of education has a prominent place in the Five-Year Plans of India. The Standing Committee of the Parliament on HRD has laid stress on universal human values of truth, right conduct, peace, love and environment. A Division has been created on ‘Education in Human Values’ in the Ministry of Human Resource Development. The Division has taken a large number of steps that have far-reaching consequences and effects on value education at all levels in the country. The Government has introduced human rights issues in the curricula. NCERT has started the process to include the CRC in the school curricula. (For details please refer to pages 308-315 of the section on Aims of Education.)

85. The Government has introduced Human Rights Issues in the Curricula. (For details please refer to pages 312-313 of the section Aims of Education.) National Curriculum Framework for School Education has introduced CRC in Schools. The process for its integration in the school curricula will be started.

H. Special Measures of Protection

Unaccompanied. Asylum Seeking and Refugee Children

86. India has been more liberal than most States in practice, by according special facilities for education, shelter and food for the refugees, thus fulfilling the provisions of the 1951 Convention and the 1967 Protocol. (For details please refer to page 331 of the section on Refugee Children.)

Children and Armed Conflict, and Their Recovery

87. One of the key priorities of the GOI in this area is to ensure a special focus on children in the National Disaster Relief Plan and contingency plans to meet emergency situations including situations of conflict. (For details please refer to pages 339-340 of the section on Children in Armed Conflict.)

Economic Exploitation

88. The reservation made with respect to article 32 of the Convention does not in any way dilute the government’s resolve to eliminate child labour. The Government is regularly reviewing the position regarding the progressive implementation of the provisions of article 32 of the CRC. (For details please refer to page 3 of the section on General Measures of Implementation.)

89. The Child Labour (Prohibition and Regulation) Act, 1986 seeks to achieve this basic objective and the government is taking all measures to implement the Child Labour Act, Bonded Labour Act, and Employment of Manual Scavengers Act. Their implementation is gathering momentum. (For details please refer to pages 373-375 of the section on Economic Exploitation.)

90. The Implementation of the directions of the Supreme Court is being monitored by the Ministry of Labour and compliance of the directions reported to the Honourable Court on the basis of the information received from the State/UT Governments.

91. As its ongoing efforts, the Ministry of Labour carries out campaigns against child labour and training of civil organisations, government officials and law enforcement officials. (For details please refer to pages 376-377 of the section on Economic Exploitation.)

92. Rapid Assessment of child Labour has been undertaken in four districts under NCLP. It is planned to undertake such studies in another 29 districts under NCLP. (For details please refer to page 380 of the section on Economic Exploitation.)

93. The GOI has initiated action on a central legislation specifying minimum age for admission to employment and work. The provisions of the proposed legislation have been drawn from the Minimum Age Convention, 1973. The Government also proposes to ratify the ILO Convention No. 182 (Worst Forms of Child Labour Convention).

Drug Abuse

94. In order to tackle the problem of drug abuse in the country, the Government has adopted a two-pronged strategy of supply control and demand reduction of drugs. (For details please refer to page 386 of the section on Drug Abuse.)

Sexual Exploitation and Abuse

95. The Supreme Court of India passed the important judgement on the subject of commercial sexual exploitation of children and women in the case of Gaurav Jain vs Union of India on 9 July 1997. The GOI has taken a number of steps in pursuance o the judgement. (For details please refer to pages 394-397 of the section on Sexual Exploitation and Abuse.) The Indian Penal Code (sections 361, 366, 366A, 366B, 372 and 373) already contains several provisions, which make kidnapping unlawful. (These provisions have been dealt in detail on page 400 of the section on Sale, Trafficking and Abduction.)

96. CHILDLINE Service has been initiated by the Government for children in distress and to respond to children in emergency situations and refer them to relevant Government and Non-Governmental organisations. (For details please refer to page 365 of the section on Physical and Psychological Recovery and Social reintegration of the Child.)

97. The State Departments of Women and Child Development are implementing various schemes for the welfare of devdasi girls. (For details please refer to pages 395-396 of the section on Sale, Trafficking and Abduction.)

98. The Convention on Preventing and Combating Trafficking of Women and Children into Prostitution has been drafted and is expected to be ratified at the next SAARC Summit. This Convention seeks to take measures to prevent cross-border trafficking through proper international governmental coordination as well as harmonizing various laws and legal provisions relating to trafficking and rehabilitation of rescued victims.

99. The GOI is in the process of amending the Immoral Traffic (Prevention) Act, 1956 (ITPA) and making punishment for traffickers more stringent and putting greater criminal culpability on them. For this purpose, the National Commission for Women has recently sponsored country wide consultations and proposed certain recommendations which are being processed for preparing an Amendment Bill.

100. India is in the process of ratifying the international Protocol to Prevent, Suppress and Punish Trafficking in Persons, especially Women and Children.

Administration of Juvenile Justice

101. The Juvenile Justice (Care and Protection of Children) Bill, 2000 replaces the existing Juvenile Justice Act, 1986. It takes into account the CRC and other Relevant International Treaties. This law has a child friendly approach and provides for proper care, protection and treatment and also for ultimate rehabilitation of children in need of care and protection. (For more details please refer to pages 340-356 of the section on Administration of Juvenile Justice.)

I. Dissemination of the Report

102. The GOI has initiated a number of measures for dissemination of the Report. The key observations and recommendations have been presented at major meetings and forums on children’s issues at national, state and district levels. The Concluding Observations are being widely disseminated through meetings and workshops, to NGOs and general public seeking information and through the internet. (For more details please refer to pages 19-20 of the section on General Measures of Implementation of the Report.)

SECTION I
GENERAL MEASURES OF IMPLEMENTATION
(Arts. 4, 42 and 44, para. 6, of the Convention)

103. As an affirmation of its strong commitment towards children, and to mainstream women in the process of development, the Government of India (GOI) set up the Department of Women and Child Development (DWCD) in 1985. The creation of a separate department was a landmark step in bringing child-related issues to the centrestage. Shortly after this, the Convention on the Rights of the Child (CRC) was adopted by the UN in 1989. In 1992, just three years later, India acceded to the CRC, becoming one of the first few countries in the world to do so. This quick accession to the CRC is proof of India’s firm resolve to promote the best interests of its children.

104. While acceding to the CRC, India had declared with regard to article 32 that “While fully subscribing to the objectives and purposes of the Convention, realising that certain rights of the child, namely, those pertaining to the economic, social and cultural rights can only be progressively implemented in developing countries, subject to the extent of available resources and within the framework of international cooperation, recognising that the child has to be protected from exploitation of all forms, including economic exploitation; noting that for several reasons, children of different ages work in India; having prescribed minimum wages for employment in hazardous occupations and in certain areas; having made regulatory provisions regarding hours and conditions of employment; and being aware that it is not practical immediately to prescribe minimum ages for admission to each and every area of employment in India—the GOI undertakes measures to progressively implement the provisions of Article 32, particularly paragraph 2 (a), in accordance with its national legislation and relevant international instruments to which it is a State Party”.

105. This reservation does not in any way dilute the Government’s resolve to eliminate child labour. It only seeks to present the ground realities and to ensure the best interests of the country with respect to any possible misinterpretation in the present global context of economic liberalisation. The Government is regularly reviewing the position regarding the progressive implementation of the provisions of article 32 of the CRC, and it has initiated the process for specifying the minimum age for admission to employment and work, in view of the commitments under the CRC and the Minimum Age Convention, 1973. The Government is also proposing to ratify the ILO Convention on the Worst Forms of Child Labour (Convention 182). Most elements of the worst forms of child labour, which the ILO Convention seeks to eliminate, are already prohibited under the CRC.

Legislative measures

106. India is governed by the Constitution which came into force on 6 January, 1950. The Constitution offers all citizens, individually and collectively, certain basic freedoms in the form of six broad categories of Fundamental Rights which are justiciable. These include the right to equality, right to freedom of speech and expression, right against exploitation, right to freedom of religion, right to conserve culture and the right to constitutional remedies for the enforcement of Fundamental Rights. The Constitution also lays down certain Directive Principles of State Policy which, though not justiciable, are fundamental in the governance of the country, and it is the duty of the State to apply these Principles while framing laws. The Directive Principles lay down that the State shall strive to promote the welfare of the people by securing and protecting as effectively as it may, a social order based on justice—social, economic and political. They also lay down that the State shall provide opportunities and facilities for children to develop in a healthy manner, and for free and compulsory education for all children up to the age of 14 years. A distinctive feature of the Indian Constitution is that the chapter on Fundamental Rights recognises children as persons entitled to fundamental rights, and this concept has been an accepted part of the domestic legal tradition from the time the Constitution was adopted. Several countries in South Asia have followed the precedent set by India and incorporated chapters on fundamental rights in their national constitutions.1

107. The major provisions of the Constitution relating to children are:

Fundamental Rights

Article 14: “The State shall not deny to any person equality before the law or the equal protection of laws within the territory of India.”

Article 15: “The State shall not discriminate against any citizen. Nothing in this Article shall prevent the State from making any special provisions for women and children.”

Article 21: “No person shall be deprived of his life or personal liberty except according to the procedure established by law.”

Article 23: “Traffic in human beings and begar and other forms of forced labour are prohibited and any contravention of this provision shall be an offence punishable in accordance with the law.”

Article 24: “No child below the age of 14 years shall be employed to work in any factory or mine or engaged in any other hazardous employment.”

Directive Principles of State Policy

Article 39: “Right of children and the young to be protected against exploitation and to opportunities for healthy development, consonant with freedom and dignity.”

Article 42: “Right to humane conditions of work and maternity relief.”

Article 45: “Right of children to free and compulsory education.”

Article 46: “To promote educational and economic interests of weaker sections to protect them from social injustice.”

Article 47: “The State shall endeavour to raise the level of nutrition and standard of living and to improve public health.”

108. Some very relevant and crucial constitutional provisions relating to children are included in the chapter on Directive Principles of State Policy, which are of guidance to the State and cannot be claimed legally. The State should strive to convert these principles into fundamental rights at the earliest so that all the rights of children can be legally asserted and their withdrawal under any circumstances not permitted. The proposed 83rd Constitutional Amendment seeking to make elementary education a fundamental right, is a step in this direction.

109. It is noteworthy that in the last three decades several major policies and action plans have been announced for improving the status of children. These include:

110. All the initiatives and programmes for the development of children have been backed by strong legislative support and political will. Primary amongst these are:

111. The commitments undertaken by India under the CRC require that legislative, administrative and other measures follow to implement specific policies which have been recognised as crucial to realising the rights articulated in the CRC, for example, a review and revision of all laws pertaining to children. Inherent in this exercise is also an obligation to review the manner in which existing laws are implemented. Accordingly, various processes along these lines have been initiated since the time the GOI acceded to the Convention.

112. Within this context, the decision of the Ministry of Information and Broadcasting to amend the Cable Television Networks Rules, 1994 (G.S.R. 710 (E), dated 8 September, 2000), is significant. This amendment categorises certain broadcasts as not suitable for “unrestricted public exhibition” and prohibits the broadcast of any advertisement that promotes directly or indirectly the production, sale or consumption of:

(a) Cigarettes, tobacco products, wine, alcohol, liquor or other intoxicants;

(b) Infant milk substitutes, feeding bottles or infant foods.

113. The Government of Delhi has amended Sections 8 and 9 of the Delhi Anti-smoking and Non-smokers Health Protection Act, 1996, in January 2001, making it illegal to sell cigarettes and other tobacco-based products to persons below the age of 18 years. Storing, selling and distributing cigarettes or other tobacco-based products within 100 metres of schools, colleges and educational institutions are illegal. Any violation of this law could lead to a fine of up to Rs 500 for the first offence and Rs 1,000 for the second offence with imprisonment of up to three months.

114. Following an order of the High Court in December 2000, Rule 37 of the Delhi School Education Act, 1973, allowing for corporal punishment for children has been struck down. The Court staunchly upheld the child’s right to life and referred to the provision provided to this effect in the Constitution, the National Policy on Education and the CRC. The Court defined the rights of the child in its widest sense of the term, “encompassing all that which gives meaning to life and makes it wholesome and worth living, something more than mere survival or animal existence”.

115. The amendment to the Cable Television Network Rule is a bold step, as the revenues from advertising of cigarettes and other tobacco products, wine and other intoxicants, infant milk substitutes, bottles and infant foods are substantial. The impact of advertising, particularly on children, has been documented and it is expected that this notification will lead to the deglamourisation of these products in the eyes of both children and adults alike. Additionally, the amendment regarding the prohibition of sale of tobacco products near schools is in recognition of the fact that children under the age of 18 years now form one of the largest growing markets for these products. The observations of the High Court while striking down the provision on corporal punishment are extremely heartening. They are proof of the judiciary’s sensitivity towards children and its recognition of the need to protect the rights of the child and to implement the provisions of the CRC.

116. In addition to these steps, the Government is considering introducing amendments to existing Acts and also new legislation to protect the best interests of the child. Some important measures proposed are:

  1. The launching of the Sarva Shiksha Abhiyaan (SSA)—the Education for All Campaign—which is a holistic and convergent scheme aimed at achieving the goal of Universal Elementary Education. This new programme has been initiated:

117. Other measures being contemplated include an amendment to the Infant Milk Substitutes, Feeding Bottle and Infant Foods (Regulation of Production, Supply and Distribution) Act, 1992, to strengthen its provisions to promote breastfeeding. Action has been initiated to ratify ILO Convention 182 on the Worst Forms of Child Labour and to specify the minimum age for admission to employment and work.

118. A unique feature in India in recent times has been the active role played by the judiciary and the Supreme Court, in particular, in upholding the rights of the child. The Supreme Court of India has developed the concept of jurisdiction under which any individual can approach the Court with regard to the violation of a fundamental right. The Supreme Court has also modified traditional concepts by allowing groups of persons or organisations to intervene on violations of fundamental rights even though they may not have a personal interest in the matter. Though group interests are pursued through social action litigation as a matter of public concern, the development is broader in scope than public interest litigation that is familiar to American jurisprudence. This concept of “social action litigation” in India represents an effort to use the legal system to ensure action to realise constitutionally guaranteed rights. A former Chief Justice of the Indian Supreme Court, Justice Bhagwati, reflected this perception of social action litigation in many of his pronouncements in decided cases and other forums. Social action litigation, in his view, is an effort to “further the cause of justice to socially and economically disadvantaged groups”.

119. Some of the most important examples of social action litigation for children are the following cases, each of which has been a landmark in the process of ensuring children’s rights:

(a) Laxmikant Pandey vs. Union of India [1984] INSC 25; [AIR (1984) SC 469, AIR (1986) SC 276, AIR (1987) SC 232] on Adoption;
(b) Shiela Barse vs. Union of India [AIR (1986) SC 1883, AIR (1988) SC 2211] on Trafficking of Children;

(c) Unni Krishnan vs. State of Andhra Pradesh [1993 1 SC 645] on Education;

(d) M.C. Mehta vs. State of Tamil Nadu [JT (1990) SC 263] on Child Labour;

(e) Gita Hariharan vs. Reserve Bank of India [(1999) 2, SC 228] on Guardianship;

(f) Centre for Enquiry into Health and Allied Themes (CEHAT) & Others vs. Union of India & Others [(2000) SC 301] on implementation of Pre-natal Diagnostic Techniques, Regulation and Prevention of Misuse, Act (PNDT).

120. While these cases will be dealt with in detail later in the report, it would be worthwhile to note the observations of the Court in the M.C Mehta case:

“The gamut of the Convention covers the full personality of the child in every dimension. Having acceded to the said instrument, that very fact is reinforcement of the tryst of the Republic with the children of India which shall be redeemed. A constellation of legislations have been enacted and many occupations and processes have been prohibited for children. Quite a few directives have been issued to the States, particularly to abolish child labour, and the Court has been at pains to pragmatise the whole situation. The right to free and compulsory education of children has been, by Court ruling, given the status of a fundamental right. The finest investment in the future for any country to make is in nourishment, physical and mental, to babies, boys and girls.”

121. The emergence of the judiciary as a champion of child rights is one of the most encouraging and significant developments in recent times. The influence and role of the judiciary will be a crucial factor in sensitising the other arms of the Government on child rights and in activating the provisions of the CRC.

122. The Constitution of India, through its Preamble, Fundamental Rights and Directive Principles of State Policy, provides for basic human rights for the people of India. In case of violations, an aggrieved person can approach a Court of Law or any competent authority such as the National Human Rights Commission, the State Human Rights Commission, etc., for redressal.2 The provisions of the CRC can be directly invoked before Courts, Commissions and other bodies in India. Wherever the provisions are reflected in the laws of the land, they are justiciable and any violation of these rights will lead to their restoration and to the imposition of penalties on the offending party. The CRC, in fact, has been a guiding document for several judicial pronouncements in India.

123. The DWCD is the nodal department in the Government for all issues pertaining to children and it is invariably consulted on all major initiatives relating to children, including amendments to existing legislation, or introduction of new legislation. This process enables the Government to reduce the possibility of any conflicts. Moreover, since the principles underlying the Convention are the same as those underlying the Constitution of India, there is little or no likelihood of any conflict arising between the Convention and national legislation.

National strategy for children

124. In September 1990, heads of State and other leaders from over 70 nations assembled in New York at an unprecedented meeting to lay down specific goals pertaining to the rights of children to survival, development and growth to be achieved by the end of the decade. Following the World Summit, India commenced the formulation of a National Plan of Action to actualize the promises made by the global community by setting out national, quantifiable goals to be achieved by the year 2000. The National Plan of Action for Children was a result of close interaction both within the government as well as outside with representatives of civil society. It reflects the needs, rights and aspirations of over 300 million children in the country and sets out quantifiable indicators to be achieved within a specific time-frame. The priority areas in the National Plan of Action are health, nutrition, education, water, sanitation and environment. The Plan gives special consideration to children in difficult circumstances and aims at providing a framework, through the goals and objectives, for actualisation of the CRC in the Indian context. It also lists out activities to achieve these goals, and identifies quantifiable targets in terms of 27 survival and development goals laid down by the World Summit for Children. Most of the goals laid down by the World Summit were incorporated in the Plan of Action but a few were modified to suit India’s requirements. In order for the goals, objectives and activities of the Plan to be more need-based and area-specific, the Central Government urged all the State/UT Governments to prepare State Plans of Action for Children, reflecting regional specificities. In response, almost all the major States have adopted State Plans of Action for Children. The mid-decade and decadal goals have been constantly monitored by a high-powered inter-ministerial committee in the Department of Women and Child Development.

125. Of the 27 goals identified by the World Summit for Children, India modified and expanded upon 12 of the goals when finalising the National Plan of Action. The major goals of the World Summit are:

126. The National Plan of Action has added to the goals of the World Summit by emphasising the “Girl Child” and the “Adolescent Girl”. It also includes goals on the child and environment, and on gender advocacy and people’s participation. The National Plan of Action has also modified some of the goals to adapt them to the situation in India, e.g. reduction of infant mortality rates to less than 60 per 1,000 live births instead of to 50 as given in the goals of the World Summit for Children.

127. The United Nations Special Assembly on Children (UNGASS) will be held in September 2001 in New York. World leaders will assemble to review the progress of the decadal goals and to lay down the course of future action. India has recently submitted a report on the follow-up action to the World Summit goals. India’s report card is mixed—high performance in some areas contrast with slow progress in others. Guinea-worm disease has been eradicated and the country is very near to eradicating polio with only 265 reported cases of the wild polio virus. The IMR has declined to 70 and 20 of India’s states have achieved the goals of IMR of 60 and less. The literacy rate in India went up to 65.4 per cent in 2001 from 52.2 per cent in 1991. During this period male literacy increased from 64.1 per cent to 76 per cent and female literacy rose from 39.3 per cent to 54.3 per cent. The status of indicators after the end-decade review of the World Summit goals is in the Annexure to this report.

128. A question has been raised as to whether a separate Action Plan for achieving child rights is required. This chapter has brought out the wide array of initiatives in India, from the Constitution to legislative support to programmes and policies. Nonetheless, gaps in the actual realisation of rights do exist for a very large number of children. An Action Plan that would enable all partners such as the Government and civil society to maximise the benefits of all efforts, rather than reiterate existing provisions, would be of immense value.

129. It is abundantly clear that much more—in terms of resources, capacity and commitments—is required if India is to realise the goals for children. While in terms of percentages, India has recorded fairly impressive gains, in absolute numbers, the children who are deprived of their rights in India is staggering. For instance, there are over 17 million child labourers at a conservative estimate—more than three times the population of Denmark. With respect to child labour elimination and tackling the debt-poverty-illiteracy cycle, it is imperative that steps are taken to break the vicious cycle through multi-dimensional interventions through constant dialogues with employers, international agencies and NGOs. At the present pace, the burgeoning population will always be ahead of all development and it is imperative therefore, that the speed of social sector development is increased.

Special government mechanisms set up to promote, coordinate and monitor measures for children at central and district levels

Nodal ministry/department

130. The DWCD, set up in 1985, in the Ministry of Human Resource Development is the nodal agency responsible for matters concerning women and children at the central level. The Minister for Human Resource Development and the Minister of State for Human Resource Development head the Department, while personnel comprise a mix of civil servants and technocrats. The State Governments also have a Department of Women and Child Development, each with a similar organisational structure. The Department formulates plans, policies and programmes, enacts/amends legislation, and guides and coordinates the efforts of both governmental and non-governmental agencies in the field of women and child development. The DWCD has the responsibility for a wide range of child development programmes and as being the nodal department for the implementation of the CRC and for coordinating the CRC reporting process, it has a strong children’s agenda. It plays a complementary role to the other developmental programmes in sectors such as health, education and rural development.

131. The most important programme that the DWCD implements is the Integrated Child Development Services (ICDS) — a scheme which is considered the world’s largest outreach programme providing a package of services comprising supplementary nutrition, immunisation, health check-up and referral services, pre-school education, health and nutrition education to almost 30 million children under the age of six years, adolescent girls, and expectant and nursing mothers all over the country. The DWCD has also steered the adoption of a National Nutrition Policy (NNP), the setting up of the National Creche Fund (NCF) and a scheme for girl children called the Balika Samriddhi Yojana (BSY)—Scheme for the Prosperity of the Girl Child. The DWCD also manages the National Children’s Fund which provides financial assistance to initiatives not covered by any other Government scheme. The mandate and schemes of the DWCD have evolved over the last 15 years and there is an effort to review this periodically in light of the obligations arising from the implementation of the CRC.

132. The DWCD is responding to immediate issues arising from the CRC reporting process and it is trying to influence other ministries and departments that are concerned with children’s issues and which operate programmes and schemes that impact on children.

133. Amongst support organisations, the National Institute of Public Cooperation and Child Development (NIPCCD), which was set up in 1975 under the DWCD, is expected to provide a comprehensive perspective on the status and needs of children and women through development, research and networking. It has been given the task of developing and promoting voluntary action in social development. In pursuit of the CRC and the National Policy for Children, it is expected to develop and promote measures and programmes for coordinating governmental and voluntary action in social development. It provides membership to institutions, non-governmental organisations and is simultaneously responsible for capacity building of NGOs through training, exposure visits and workshops. Its Resource Centre on Children provides documentation and information services in the field of public cooperation and child development. The National Resource Centre on Child Labour (NRCCL) was set up in March 1993 with the objective of assisting Central and State Governments, NGOs, policy makers, legislators and social groups through a variety of interventions and to develop capabilities of the target groups. The NRCCL has compiled a large documentation on child labour and is now assisting the Ministry of Labour, GOI, in the implementation of Child Labour Projects. Besides collaborating with ILO, UNICEF and various State Labour Institutes, the NRCCL has established a network with about 400 NGOs and trade unions for the purpose of assisting them in the implementation of child labour programmes.3

134. A number of ministries, departments and autonomous institutions are responsible for many important aspects of the CRC in the Central and State Governments. These include the Department of Education, Ministry of Health and Family Welfare, Ministry of Social Justice and Empowerment and the Ministry for Labour. The values and principles contained in the CRC are being incorporated in the Government’s sectoral policies and programmes systematically at different levels.

135. The Ministry of Social Justice and Empowerment, set up in 1985, is responsible for formulation of programmes and policies aimed at empowering the socially and economically weaker sections of the society. The Ministry has the responsibility to cater to the requirements of neglected and marginalised, abandoned destitutes, neglected and delinquent children, physically challenged children, children of sex workers, children of socially backward classes of the society, the street children and any child in need of care and protection. The policies and programmes aim at equipping these children to sustain a life of respect and honour and become useful citizens of the country. The Ministry thus looks after the welfare and all-round development of the marginalised and destitute children.

136. With the objective of strengthening coordination at the central level, a National Coordinating Mechanism (NCM) was constituted in January 2000 through an executive order issued by the DWCD for monitoring the implementation of the CRC. The NCM is chaired by the Secretary, DWCD, and its members include the Joint Secretaries of the relevant ministries and departments, viz., Ministry of Labour, Ministry of Social Justice and Empowerment, Department of Education, Department of Health, Department of Family Welfare, Ministry of Law, Department of Legal Affairs, NCW, NHRC, a UNICEF representative and four NGOs. The Joint Secretary (Child Welfare) in the DWCD is the Member Secretary of the NCM. The NCM held its first meeting in September 2000 and it is expected that in 2001 it will clearly evolve its role in relation to the implementation and monitoring of the CRC in the country.

137. India is the world’s most populous democracy, and Indian society is extremely pluralistic. The Indian political system is federal, comprising of 28 States and seven Union Territories. Through recent constitutional amendments, three new States have been carved out of bigger states in response to popular sentiments and compulsions of governance. The trend towards decentralisation has resulted in the devolution of increasing authority to the three-tiered system of governance at the district and sub-district level called the Panchayati Raj and the Nagar Palikas in rural and urban areas, respectively. Thus, the implementation of the general measures of the CRC has to be seen at all the different levels and in conjunction with one another.

138. Monitoring is a very important aspect of all programme implementation and all initiatives are regularly monitored by the Departments implementing them and any other agency which may also be involved in the programme. Professional bodies carry out monitoring and evaluation to provide independent analysis and the Planning Commission of India, for example, commissions its own studies in this regard. The information collected is fed back into the programme for corrections, modifications or additions. Sometimes, schemes which no longer serve a purpose are phased out and new schemes initiated in their place. Over a relatively short period of time, India has built up an impressive stock of reliable data based on monitoring studies and evaluations.

139. A high-powered National Commission for Children (NCC) to address the CRC agenda and to proactively actualise the provisions of the CRC is on the anvil. Towards safeguarding the constitutional and legal rights of children specifically, the NCC will be set up shortly on the lines of the National Human Rights Commission (NHRC). It is likely to be headed by a retired judge of the Supreme Court and it will have six members who will be from the fields of primary education, social action in child care, law (with special emphasis on juvenile justice), social work (with experience and commitment to the care of neglected children) and child labour. The member secretary will be of a rank not lower than that of a Joint Secretary to the GOI. It is expected that the NCC will be empowered to take up the issue of special courts for children and also order punitive action in case of violation. Like the NHRC it may also have State-level bodies.

Data Collection

140. India has a very well developed statistical system and it is one that the country is justifiably proud of. The Registrar General of India, the National Sample Survey Organisation, the International Institute of Population Sciences and other organisations conduct regular surveys on a large set of indicators and report trends at the National, State and District levels. Different sources of data such as the National Population Census, the Sample Registration System, National Sample Surveys, and National Family Health Surveys, amongst others, provide a wealth of information.

Civil Registration System (CRS)

141. The Registration of Births and Deaths has been made compulsory throughout the country under the Registration of Births and Deaths Act, 1969. At the National level, the Office of the Registrar General, India, coordinates the birth and death registration activities in the country and also compiles data relating to birth and death registration. As per the provisions of the Act, a Chief Registrar has been appointed for every State/Union Territory and under him there are District Registrars. Under the District Registrars there are Registrars who actually do the registration of births and deaths, issue birth and death certificates and also compile the basic data. There are about 200,000 reporting units and more than 100,000 registrars in the country.4

The Census

142. The Indian census tradition dates back to 1872, when the first all-India census was conducted on a non-synchronous basis and 1881, when the first synchronous census was conducted. The Indian census, conducted every 10 years, is arguably one of the largest nationally administered exercises in the world counting as it does every man, woman and child in the second most populous country in the world. It must be noted that there are very few countries in the world with a history of uninterrupted decennial census going back to 1881. The Census of India 2001, has introduced several new and useful questions as well as modifications in earlier questionnaires, and marks a bold step in taking the census way beyond a head count. The 2001 census, the 14th Indian census, involved over two million enumerators and supervisors. The Indian census is among the most accurate in the world, with an error margin of less then two per cent. This is primarily because India follows the “door-to-door” technique unlike most developed countries, which have switched to a postal head count. The first phase of the census is a reconnaissance operation—a comprehensive listing of all the houses and households in the country. This was completed during April–September 2000, in a phased manner. In February 2001, a huge army of enumerators spent about 25 days “arguing with suspicious security guards, rowing to inaccessible islands and plodding across paddy fields” to count every single Indian5 —an awe-inspiring task indeed!

The Sample Registration System (SRS)

143. The SRS is a large-scale demographic survey for providing reliable annual estimates of birth rate, death rate and other fertility and mortality indicators at the national and sub-national levels. The SRS was initiated by the Office of the Registrar General of India on a pilot basis in a few selected States in 1964–65. It became fully operational in 1969–70 covering about 3,700 sample units. At present, SRS covers 6671 sample units (4436 rural and 2235 urban) in all States and UTs. The sample unit in a rural area is a village or a segment of it, if the village has a population of 1500 or more. In urban areas, the sampling unit is a census enumeration block with a population ranging from 750 to 1000. The SRS bulletins, published twice a year in April and October, and provide estimates of birth rate, death rate and IMR at State level while the statistical report published annually provides detailed data on fertility and mortality.

The National Sample Survey Organisation (NSSO)

144. The NSSO was set up in 1950 with a view to having a permanent survey organisation to collect data on various facets of the economy through nation-wide sample surveys in order to assist in socio-economic planning and policy making. The NSSO covers different subjects of importance, such as employment and unemployment, consumer expenditure, land holdings, livestock enterprises, debt and investment, social consumption, demography, morbidity and disability through household surveys. The National Sample Survey is a continuous survey in the sense that it is carried out in the form of successive “rounds”, each round usually of one-year duration covering several topics of current interest in a specific survey period. The survey programme conforms to a cycle over a period of 10 years, some topics being repeated once in 10 years and some being repeated once in five years. Subjects of special importance are also accommodated in the intervening years or covered along with regular repeated surveys. At present, an NSS round at the all-India level surveys about 12,000 to 14,000 villages and urban blocks in the central sample (covered by the central agency, the NSSO) and an independent sample of about 14,000 to 16,000 villages and urban blocks in the State sample (covered by the Governments of various States and UTs).

145. Some of the recent surveys include:

Central Statistical Organisation (CSO)

146. The CSO is responsible for the formulation and maintenance of statistical standards, work pertaining to national accounts, industrial statistics, consumer price indices and conduct of economic census and surveys. The CSO conducts the Economic Census for collecting data on distribution of non-agricultural enterprises and to provide a frame for follow-up surveys for collection of detailed information about the structure of enterprises, investments, loans input and output, employment, contribution to national economy, etc. The fourth Economic Census was conducted during 1998–99 in all States/UTs.

National Family Health Survey (NFHS)

147. The first NFHS was conducted in 1992–93 and was successful in creating an important demographic and health database in India. The second Survey, NFHS-2, was undertaken in 1998–99, and was designed to strengthen the database further and facilitate implementation and monitoring of population and health programmes in the country. The NFHS surveys provide national estimates of fertility, infant and child mortality, maternal and child health, and the utilisation of health services provided to mothers and children. In addition, the survey provides indicators of the quality of health and family welfare services, women’s reproductive health problems, and domestic violence, and includes information on the status of women, education and the standard of living. The NFHS-2 survey covered a representative sample of more than 90,000 eligible women between the ages of 15–49 years from 26 States that comprise more than 99 per cent of India’s population. The survey provides State-level estimates of demographic and health parameters as well as data on various socio-economic and programmatic factors that are critical for bringing about the desired changes in India’s demographic and health situation.

National Council of Applied Economic Research (NCAER)

148. The NCAER conducted a survey of 33,000 rural households in 1994 to create a Human Development Profile of India. The survey was spread over 1,765 villages and 195 districts in 16 States of India. About 90 indicators of human development that reflect various dimensions of levels of living such as income and assets, employment and wages, consumption expenditures, literacy, morbidity, under-nutrition, demographic rates and health care utilisation were assessed. Population groups based on household income, poverty line criteria, land ownership, occupation, caste and religion, household size, adult literacy, and village development were covered in the survey.

Multiple Indicator Cluster Surveys (MICS)

149. The MICS were first conceived in India by UNICEF, India, as part of the Child Survival and Safe Motherhood (CSSM) programme when the EPI Cluster Evaluation Surveys were modified as a part of the CSSM programme in 1992 to include additional indicators related to vitamin A coverage, diarrhoea morbidity and treatment practices and the safe motherhood component of the programme with emphasis on quality and ante-natal care, place and type of assistance during delivery. UNICEF, India, has been conducting MICS in a number of States, districts and towns (including specific surveys for urban poor populations) for nearly four years now. Over 175 surveys have been conducted at various levels and have been used at the level that they are conducted. India was one of the countries included in the Global Evaluation of MICS conducted in 1996. Currently, the MICS II is being implemented in India to measure progress towards the end-decade goals, adopted at the World Summit. The survey covers indicators related to health, nutrition, education, child labour, water and sanitation.

Others

150. There is also a vast body of other sample surveys conducted by Government departments, institutions and professional bodies, which provide data on several aspects of child rights such as household expenditures on education and health, child labour, household enterprises, and nutrition distribution at the household level, amongst others. An example in this regard is the Sixth All India Educational Survey (AIES). The National Council of Educational Research and Training (NCERT) has been organising educational surveys and publishing survey reports which provide detailed educational statistics and information for planning. Six such surveys have been organised so far. The Sixth All India Educational Survey was initiated as a joint product with the National Informatics Centre (NIC) for creating an effective database on school education. Computerisation of this survey data had twin objectives—to build up a database on school education at district/State headquarters to facilitate and update essential information, and to make available data on electronic media for a wider dissemination of reports generated for various administrative units. The Sixth AIES was conducted with reference date as September 30, 1993. In addition, the Bureau of Economics and Statistics and the Departments concerned compile data at the State level. The compiled data is utilised mainly for monitoring and review and also for periodic evaluation of the statutes and schemes covered under the CRC. Thus, schemes that are relevant to the CRC may be considered part of the overall activities to which existing data collection procedures are applied.6

Involvement of civil society

151. Civil society organisations are involved in almost all the programmes/schemes undertaken by the GOI and the State Governments. Suitable mechanisms have been devised by the Government such as periodic review meetings and submission of progress reports from time to time by NGOs, so as to evaluate the progress achieved by them. Many NGO initiatives have been discussed later under relevant sections. At the national level, key initiatives in collaboration with civil society organisations include an awareness campaign against firecrackers and child labour, among schoolchildren in Delhi by the National Foundation of India. This led to thousands of children taking a pledge against the use of firecrackers on Diwali—the festival of lights, one of the largest festivals in the country because these are produced by child labourers in Sivakasi in Tamil Nadu.

152. A significant partnership developed when the Indian Medical Association took up the fight against female foeticide, with doctors and other medical practitioners as the target group. The Voluntary Health Association of India and the Centre for Child and the Law, National Law School, Bangalore, have been actively involved in this initiative and many schools held debates and poster competitions for children, encouraging their participation on this issue. As a result of these steps, mass awareness has been generated, and public attention has been drawn to this practice.

153. Gujarat has been trying to involve NGOs not only in the implementation of schemes, but also in obtaining inputs for the formulation of new schemes and modifications to existing schemes. In fact, Gujarat has a long-standing tradition of promoting the implementation of schemes through NGOs.7 In Andhra Pradesh, collaboration with the MV Foundation focused on the promotion and protection of child rights in institutions, training staff of homes under the Juvenile Justice Act and the establishment of the Teachers Union on Child Rights.8

154. In addition, there are several active NGO networks on child rights issues in the country. Some of the key networks involved in systematic awareness creation, advocacy, mobilisation and campaigning on child rights are mentioned below:

Rajasthan, which has a network of NGOs, departments, corporations and media in 10 districts for children in need of special protection measures, a network for children in need of special protection measures, a network of NGOs on disability and a major network of NGOs in 15 districts working for street and working children.

Andhra Pradesh, where the Andhra Pradesh Child Rights Forum (APCRAF) has a network of 36 NGOs from 20 districts involved in training NGOs on the CRC and awareness and dissemination activities at the community level. The Andhra Pradesh Alliance for Child Rights (APACR) has 250 NGOs in 17 districts and has been involved in training and dissemination activities.

Gujarat, where NGO Forums for Child Rights have been set up in Ahmedabad and Vadodra with about 65 NGOs which have familiarised themselves with the provisions of the CRC and have begun to review implementation of CRC in the State.

Tamil Nadu, where NGO networks campaign against child labour and bonded child labour, sex-selective abortions, foeticide and infanticide. NGOs are active partners in the implementation of various programmes in the State.9 NGOs run a large number of programmes, including setting up and running of crèches, nutritional centres, orphanages, juvenile guidance bureaux, programmes for street and working children, and drug de-addiction programmes. These programmes are supported by the State Government of Tamil Nadu and the Central Government. NGOs are also involved in the high level committee for adoption, juvenile welfare board, etc.10

Maharashtra, where the Forum Against Child Sexual Exploitation (FACSE) has prepared a State Plan of Action in collaboration with the Government, NGOs and UNICEF to place mechanisms in schools and hospitals to tackle the problem. ARC, Action for Rights of the Child, started in 1989, has made significant contributions to promoting the rights of marginalised children to education.

Bihar, where seven Child Rights Collectives have been formed at Saran, Siwan, Patna, Nalanda, East Champaran, Begusarai, and Vaishali.

Uttar Pradesh, where an NGO network on child rights has been announced with a membership of around 100 NGOs and will become operational shortly.

155. It is difficult to capture the wide range of activities of NGOs in such a large country. By and large, the NGO networks are stronger and more systematic in their work in the southern part of the country. A systematic analysis will be made of NGO efforts in the field of child rights to fully understand their contributions in implementation of CRC, and evolve a systematic plan for partnership with NGOs in planning, implementation and monitoring CRC implementation in the country.

156. The media plays a critical role in shaping public opinion and creating mass awareness. GOI and UNICEF collaborative initiatives over the years have focused on enhancing the capacity of the electronic and media and media units of the Ministry of Information and Broadcasting to integrate and represent issues concerning children and their rights effectively. Partnerships with the media have steadily increased over the years with a perceptible rise in reportage on child rights and children’s issues. A wider range of sensitive issues, including child labour, child sexual abuse and violence, is being covered with more in-depth, investigative and concerned reporting.

157. The National Human Rights Commission, in collaboration with UNICEF, organised a series of four regional consultations in 1999–2000 for the electronic and print media and a number of partners, including the police, judiciary, NGOs, functionaries from different State Government departments on child sexual abuse. As a direct result of this, reporting on child sexual abuse cases in the media has increased and many sensitive programmes have been aired on TV and radio. A set of guidelines for the media on reporting child abuse, trafficking and child prostitution has been developed, released by NHRC and widely distributed to media professionals. The All India Radio and Doordarshan (TV) have broadcast the Meena series of films and held talk shows and other programmes to highlight girl child issues throughout the year, especially during the Girl Child Week in September.

158. The most significant and visible change is that the media is gradually focusing on children’s issues in a qualitative way. This bodes well for the future and it is expected that the media will increase its responsibility to include monitoring of child rights violations also.

Dissemination of the CRC and the Concluding Observation

159. Amongst the steps taken to disseminate the CRC and the Concluding Observations of the Committee on the Rights of the Child to India’s Initial Report are:

(a) The CRC has been translated into 13 major Indian languages with assistance from UNICEF and disseminated through State Governments, NGOs, meetings, trainings, press briefings and events;
(b) Universal Children’s Day, Girl Child Week, Nutrition Week, World Breastfeeding Week, have been some of the events around which the Government, NGOs and UNICEF have organised major campaigns and mass awareness drives on child rights issues;
(c) Multi-media campaigns have been organised to mobilise people for immunisation, pulse polio, prevention of HIV/AIDS, elimination of child labour, and education for all, as well as for highlighting the positive image of the girl child and questioning the gender bias in society;
(d) Special programmes on the elimination of child labour, highlighting the impact of hazardous employment on the health and development of working children are also disseminated through print, radio and other electronic media. Articles and supplements on child rights issues appear in major newspapers quite frequently. Doordarshan routinely telecasts films, documentaries, tele-serials and spots on the rights of the child and on issues like street children, disabled children, juvenile delinquents, child beggars and child education on its national as well as regional networks. There have been qualitative improvements in the programmes over the years and programmes have increasingly tried to encourage children to express their views, beliefs and experiences;
(e) The key observations and recommendations have been presented at major meetings and forums on children’s issues at National, State and District levels. The common areas of observations and recommendations in both the CRC and the Convention on the Elimination of All forms of Discrimination against Women (CEDAW) concluding observations have also been highlighted;
(f) The Concluding Observations have been shared with different sectoral government counterparts in States, leading NGOs, some professional associations, judicial activists and journalists;
(g) The Concluding Observations are being looked at as a tool for guiding programming decisions and incorporating recommendations for action in ongoing programmes;
(h) By and large, NGOs have been actively using the Concluding Observations at their meetings systematically, to come together for identifying key areas for action as well as building a critical mass of concerned individuals and organisations to mobilise government consideration and action on the concluding observations. Available reports indicate discussions and debate around the Concluding Observations in Mumbai, Andhra Pradesh, Karnataka, Manipur and Delhi. These are also the places from where the NGO alternate reports on the Initial CRC Country Report were made;
(i) The Concluding Observations have been printed and are being widely disseminated through meetings and workshops to NGOs and the general public;
(j) A simplified public information version of the Concluding Observations has been prepared and is being disseminated. This will also be translated into major regional languages. A children’s version is in the process of being developed;
(k) The Concluding Observations have been translated into Hindi, Bengali and Assamese.

Dissemination of CRC to children

160. There has been a gradual expansion in efforts by the States to make the Convention known to children. At the National level, the National Council for Educational Research and Training (NCERT) is conducting a curriculum review and has been requested by DWCD to incorporate CRC in the school curriculum. This has been agreed to in principle. The challenge will be to prepare appropriate teaching materials for different age-groups and orient teachers for taking this on at a national scale.

State initiatives in this regard include:

(a) Uttar Pradesh, where material has been prepared for children on the CRC, including posters and a magazine (Bal Bagiya). Meena video cassettes and accompanying materials have also been used extensively in districts, promoting child participation. Rights Awareness Week (14-20 November) and Girl Child Week (18–24 September) have been used by NGOs and educational institutions to create awareness on child rights among children;
(b) Karnataka, where rallies marking Child Labour Day on April 30 were held across the State. Through Campaign Against Child Labour, awareness campaigns on CRC were held across 27 districts;
(c) Tamil Nadu, where advocacy to include CRC in the curriculum of schools is going on, based on the success of an initiative in the State in which 800 schools have incorporated human rights education;
(d) Gujarat, where the main outreach has been through the child participation initiative, in which materials have been developed by children on CRC issues;
(e) Bihar, where the CRC has seen several forms—as cartoons done by The Times of India artists, as rhymes by the women of West Champaran district and as Meena paintings and stories (one for each article). There is also a primer, a dictionary, an FAQ and a history of CRC. The CRC has also been the subject of Bal Samachar (Children’s News) brought out by children themselves in several districts of Bihar. Children are also being reached through several Child Rights Spokespersons in the State who demystify CRC and CEDAW, and produce materials for children on child rights. Meena Clubs in the districts reach out to children and community members on child rights issues with a focus on girl child issues. Over the last three years, over 1000 schools in 45 districts have participated in the Child Rights Congress after receiving orientation on CRC;
(f) Madhya Pradesh, where awareness of CRC among children is the first step in promoting child participation. The Madhya Pradesh Human Rights Commission has held awareness camps in schools about human rights and CRC. Mass awareness initiatives reach out to large numbers of children through special communication efforts during Girl Child Week and Child Rights Week.

161. NGOs have been taking initiatives to disseminate the CRC. A few examples are:

(a) The North-West Programme of Save the Children Fund (UK) operating in Jammu & Kashmir has produced multilingual booklets that are aimed principally at children to make fully aware of the various provisions of the Convention, and to enable them to work towards the realisation of their rights;
(b) Small booklets called “I have rights and responsibilities” have been published by SCF and UNICEF, Delhi;
(c) Action for the Rights of the Child based in Pune has been coordinating the publication of pictorial booklets enumerating the rights of the child. The booklets are sponsored by UNICEF;
(d) The Tamil Nadu Primary School Improvement Campaign aims at building awareness through campaigns on child rights, specifically the child’s right to education;
(e) Madhyam, an NGO in Bangalore, has been printing colourful posters with messages on child rights;
(f) Aashray, situated in Andhra Pradesh, has been working on awareness programmes on child rights among community leaders and members of the community and children;
(g) The Indian Council for Child Welfare, Tamil Nadu, has been publishing a newsletter, in which a column has been allocated for child rights;
(h) IPER, a Kolkata-based NGO, has translated the CRC for children into Bengali.

Capacity-building training for CRC

162. The size and complexity of India and the structure of the Government make it difficult to capture and define a national overview of the capacity development initiatives that have been put in place for accelerating the implementation of CRC. There are some training institutions governed by the Central Government and others which come under the jurisdiction of State Governments. For instance, the Lal Bahadur Shastri National Academy of Administration, Mussoorie and the Sardar Vallabhbhai Patel National Police Academy, Hyderabad, are responsible for the training of Indian Administrative Service (IAS) and Indian Police Service (IPS) officers. Graduates from these academies hold key decision making positions in the Indian bureaucracy. So far, training inputs on child rights have been in the form of panel discussions and presentations by programme staff, activists or NGOs. The Centre for Child and the Law, National Law School, Bangalore, is developing a curriculum for the IAS academy which will need to be incorporated into the training calendar. In a welcome move, the Police Academy has integrated CRC into its ongoing training programmes. The GOI, through NIPCCD, organises several training programmes for NGOs and other professionals working with or for children, in which the CRC provisions are highlighted.

163. Training for different categories of people dealing with children has been going on in India since Independence. All through the Five Year Plans with every child welfare measure taken by Government to fulfil the rights of children as enshrined in the Constitution, training modules and institutions were developed from the grassroot point to the Central level in accordance with programmes undertaken, such as, Applied Nutrition Programme, Balwadi Programme, ICDS, Juvenile Justice, etc. Efforts are on to re-orient the training strategy for field level workers and the community towards child rights. The process has already started to re-orient the existing training programmes pertaining to Early Childhood Development, Health and Family Welfare, Elementary Education, Rural Development towards the concept of child rights. NIPCCD has already initiated the process of re-orienting its training syllabus towards CRC and some State Governments have also done so. NGOs, staff and organisations working with the Labour Department, Police Department and children have also been trained in the CRC in several States. This process is still under way and should gain momentum at District and State levels. In view of the federal de-centralised nature of administrative functioning in the country, it is difficult to report on actual numbers of persons trained by category in India.

164. Key child rights training initiatives from a few States are as follows:

Bihar: Nalanda Open University has launched a certificate and Diploma course in CRC and CEDAW. Over 500 adults, many of them journalists and artists, participated in a four-day intensive Child Rights Spokespersons Course, preparing them as advocates of child rights. Forty school-teachers have been trained as master trainers for furthering CRC orientation in schools. National Service Volunteers and other youth have been oriented through Nehru Yuvak Kendras and the Legal Aid Committee of South Bihar.

Tamil Nadu: Training resource groups available in the State include the Human Rights Advocacy and Research Foundation, Indian Council for Child Welfare and the Centre for Child Rights and Development. Training of trainers for dissemination of CRC through folk media has also been conducted in the State. Several training programmes have been held, including training of Juvenile Justice Act functionaries, teachers and frontline workers of five National Child Labour Project districts, labour inspectors and municipal commissioners and elected representatives in the same districts. Members of the Inter-media Publicity Coordination Committee and some journalists in the State have received CRC orientation.

Andhra Pradesh: The Andhra Pradesh Academy for Rural Development (APARD) and the Andhra Pradesh Police Academy have incorporated CRC in the curriculum for ongoing training of Government officials. Over 480 trainers of APARD have received CRC training and 80, 000 elected representatives have been oriented in CRC. Training of local bodies on CRC was undertaken by the Regional Centre for Urban Environmental Studies. The Andhra Pradesh Police Academy has sensitised police officials on child rights. Teachers have received CRC orientation under special projects.

Uttar Pradesh: State resource teams have been trained on CRC and are reaching out through more than 250 motivators to cover 10,000 children and adolescents, community members across the State, several government departments and institutions. The Institute of Judicial Training and Research has integrated issues of child rights and juvenile justice for reaching the Chief Judicial Magistrates. The Prathmik Shishak Sangh, with a membership of 250,000 teachers, is being reached through the Teachers’ Union whose resource teams have been trained in CRC. The State and district urban development agencies and NGOs have been oriented on child rights for strengthening child rights through community development societies.

Gujarat: CRC training has been organised for NGOs, academic institutions and police officials in the State to sensitise them on protection measures for street and working children. Capacity building among staff of the Surat Municipal Corporation and Government officials has been carried out.

Madhya Pradesh: The State has given focused attention to the training of police officials, Panchayati Raj members, teachers, doctors, NGOs, youth organisations and field functionaries of various sectoral programmes have also received CRC orientation as part of their refresher training.

Karnataka: The State has been conducting CRC training of Government officials, NGOs, youth counsellors and trainers of Nehru Yuvak Kendra for training youth as advocates for children. An NGO, ‘Mythri’, has developed training programmes at various levels. A police training guidebook has been produced with the help of BOSCO (an NGO in Bangalore) and the Ministry of Welfare and Home Affairs. A police pocketbook on tips for being child-friendly has also been developed to be used in conjunction with the training.

Maharashtra: A recent decision regarding training of judges in the State requires incorporation of a two-day module on child rights in all training programmes for judges. A small core group is being set up in the State to develop this module using the experience of NGOs working with children who come in conflict with the law. The Police Training Academy of Maharashtra is to institutionalise CRC training into in-service and pre-service training programmes and there is a proposal to train all trainers of the nine Police Academies in the State. Training modules will be developed to standardise the training by a special core group.11

CRC reporting process in India

165. India acceded to the Convention on the Rights of the Child on December 11, 1992, thereby affirming its commitment towards children and their rights. India submitted its Initial Report, referred to as the First Country Report to the UN Committee on the Rights of the Child in February 1997. The UN Committee on the Rights of the Child, based on the First India Country Report, sought clarifications on more than 38 issues pertaining to the Convention. This List of Issues was sent to the relevant departments for feedback and to the Alternate Report NGOs and Schools of Social Sciences, leading national institutions and organisations for their comments. The replies to the List of Issues were printed as a booklet and distributed at the National and State levels and sent to the Committee on the Rights of the Child. India received the comments and concluding observations from the Committee on the Rights of the Child based on its Initial State Party Report in January 2000.

166. The first periodic country report preparation process commenced in August 1999 and DWCD requested State Governments to initiate the process with state sectoral departments, NGOs, professional bodies and other civil society representatives, and submit State reports as inputs for the national report. To assist in the compilation of State inputs, DWCD prepared questionnaires based on the Committee’s guidelines for preparation of periodic reports and shared these with the State Governments as well as Central Ministerial Departments.

167. Different States have adopted different processes to come up with inputs for the national report and these have varied in how participatory they were. In some States, children, NGOs and the media participated extensively; in others, the reporting was mainly based on inputs received from Government departments. NGO participation in the preparation of the State reports is in addition to the regional consultations, and cannot be accurately quantified. A brief description of the reporting process in three States is given below:

Rajasthan: Beginning with an inter-departmental meeting, the process was expanded to include participation and views of a wide cross-section of society, key groups being NGOs, individuals, Indian, government functionaries and children themselves. Through workshops, their views, experiences and suggestions regarding child rights were invited and incorporated in the report.

Andhra Pradesh: The NALSAR University of Law organised three regional consultations in the State to document developments in coastal Andhra, Rayalseema and Telangana regions. NGOs working with child rights and vulnerable groups were invited. Views of children were obtained and facilitated by Save the Children. Judicial Magistrates, educationists, school teachers, labour officers, and juvenile justice officers were also involved.

Tamil Nadu: Various departments responsible for programmes directly related to children were contacted and requested for relevant information for the Second Country Report through the following process:

So far, 17 States have submitted their inputs to the Central Government and another three State reports are expected. Inputs from some Central ministries have also been received.

168. The DWCD has also put the questionnaires on their website together with a special questionnaire requesting information from NGOs about their activities in the field of child rights. An advertisement was put in the national dailies giving this information and inviting contributions from NGOs.

169. In order to have more direct feedback from NGOs for both the CRC report as well as the End-Decade review of the Goals report, four regional consultation workshops were held between October 30 and November 11, 2000, at Mumbai, Lucknow, Guwahati and Bangalore. A mix of community-based NGOs and those with experience of national/global meetings on child rights were invited to these workshops. In all, 168 NGOs from 23 States participated in these workshops. Inputs from these workshops are being incorporated into the preparation of both the End-Decade Progress on the Goals Report and the CRC Periodic Report. Child representatives from 11 States participated in these consultations representing children’s views and concerns. The representatives were selected by children from the States after a dialogue/consultation process in the State-level projects that have initiated the process of child participation. The children were made to understand the rationale for these consultations and given a chance to prepare for these meetings. They were given an opportunity to let their voices be heard and to select their representatives. This process of regional consultations was facilitated jointly by NIPCCD for the GOI, UNICEF and SCF. The draft report incorporating all the State inputs was circulated to all Central Government departments and State nodal departments for comments within a fixed time-frame. The final editing was then done by the nodal ministry based on the feedback and suggestions received. UNICEF facilitated and provided support in the report preparation process both at the National and State levels.

170. Recommendations of NGOs for strengthening CRC implementation: Some excerpts from the four regional NGO consultations—October 30–November 11, 2000

Increase awareness about child rights

Accelerate training and capacity building for realisation of child rights

Setting up coordination mechanisms for CRC implementation at various levels

171. A permanent State-level committee is required to be set up for the implementation and monitoring of CRC. The committee should have representation of NGOs working in the field of child rights, social workers, experts and representatives of minority groups, legal experts and government functionaries of all key departments who are at a decision making level. Local leaders, as well as people’s and child representatives should be closely involved with the functioning of this committee. They should be oriented and sensitised about CRC and the role of the committee.

172. There is a need for a State-level cell linked with the National Commission for Children under the Chairpersonship of the Chief Secretary. The Government should fund the cell. The cell should be responsible for:

173. It is imperative to empower existing Committees set up for children’s programmes to monitor child rights status at State, District, block and village levels. It should be in consultation with and have representation from Government, civil society, NGOs, Gram Panchayats and children.

174. Lack of accountability, information and proper documentation hinders effective coordination and monitoring of child rights at all levels. Urgent action is required to strengthen these aspects.

175. A National Commission for Children with financial autonomy and powers to enforce the laws related to child issues should be constituted, consisting of individuals from different walks of life. It should have bodies at National, State and District levels and should disseminate information on children’s rights to the public and should be involved in policy decisions on children.

176. An experiment in this direction is taking place in Uttar Pradesh through the setting up of a child rights development unit in joint collaboration with the Department of Women and Child Development and the NGO network on child rights in Uttar Pradesh.

Data collection and use for influencing policies and programmes for children

177. Each State should have a coordination committee to collect data on all aspects of child rights. Existing data collection systems need to be reviewed, as there are many areas where adequate and disaggregated data are not available. This includes gender disaggregated data, and information on various forms of child abuse and exploitation, child labour, children affected by conflict/militancy, trafficking of children, tribal and indigenous children and their condition, crimes committed against children, condition of children in state-run institutions, etc.

Promoting child participation

Pre-requisites for child participation:

Constraints to effective implementation

Girl child

Child labour

General recommendations

Box 1.1: Voices of Children
Girls want to be treated the same as boys. They should not be made to work at home. They want to go to school just like boys.
Children say they should not be forced to work. All child labourers must be cared for and allowed to go to school and learn skills for life.
Children want peace, and violence frightens them. Many children are orphaned or get hurt and have emotional and psychological problems.
They have to leave studies and work at home.
Adults must not force children to marry. Girls thought that this deprived them of an education and a chance to do well in life. They felt that parents should be educated against child marriage, and all adults who force children to marry should be punished.
Schools should not be far away. There should be teachers in the school and the teachers should not punish or beat the children. Books and uniforms must be made available. Children would like to study in their own language.
Parents who do not send their children to school should be punished.
Sale of alcohol, drugs and addictive substances should be banned. Parents should not drink alcohol or take drugs. They should not beat children, and send them to work because they do not earn themselves or make them want to run away from home.
The police harass street and working children. The police and others working for children should be friendly and trained to be helpful. There should be shelters for children so that they can be safe at night.
Children felt that health centres should have medicines. Health services should reach people in remote areas. They felt that trained female staff should be available to help out at the time of birth. Mobile health vans should serve areas where there are no health centres.
Children wanted employers of child labour punished.
Elders should provide opportunities for children to participate. This increases the confidence of all children, especially girls.
Children from Maharashtra and Rajasthan said that there was a water problem. Children spent long hours in filling water from distant places, which affected their studies.
Children from urban slums felt they had no time and place to play.
All our hopes are the same, wherever we come from. You adults have heard us. Tell us what you are going to do now.” Nawaz, age 9, Mumbai consultation.
Excerpts from the four regional NGO consultations, October 30–November 12, 2000

International cooperation

178. The World Bank has supported early childhood development efforts in India since 1980 through a number of projects. The Integrated Child Development Services-II Project is currently being implemented in the States of Bihar (210 blocks) and Madhya Pradesh (244 blocks) with a total outlay of Rs 5,962 million (Madhya Pradesh: Rs 3,391 million, Bihar: Rs 257 million). The approved IDA credit is US$ 194 million. The Integrated Child Development Services-III/Women and Child Development Project (1999–2004) covers the five States of Kerala, Maharashtra, Rajasthan, Tamil Nadu and Uttar Pradesh. The approved IDA (World Bank) credit over the project period is US$ 300 million (including the nationwide training component) covering 1,003 blocks. The Integrated Child Development Services-Andhra Pradesh Economic Restructuring Project (APER-1998–2004) was approved in March 1999. It covers a total of 251 blocks thus universalizing ICDS in rural and tribal areas. The total outlay is Rs 3,927.5 million with IDA (World Bank) credit of US$ 75 million.

179. The World Food Programme (WFP), a United Nations agency, under its Project 2206 extends food aid for supplementary nutrition to children below six years of age and to expectant and nursing mothers under the ICDS programme. The Better Health and Nutrition (BHN) Project (with a total cost of Rs 17.56 million) is being implemented in Sirohi and Udaipur districts in Rajasthan since March 1997. CARE-India’s Integrated Nutrition and Health Programme (INHP) is being implemented in all seven CARE-assisted States. This five-year programme is in operation from April 1996 to March 2001 with a total budget of Rs 1131.6 million aiming to improve the health and nutritional status of women and children.13

Strategy for implementation of programmes/policies

180. Human development and improvement in the quality of life are the ultimate objectives of all planning. In India, this is achieved through services and programmes aimed at the promotion of both equity and excellence. Planning takes into account the resources required for human development and the human resources available for carrying out the plan.

181. In India, planning derives its objectives and social premises from the Directive Principles of State Policy. India follows the system of Five-Year Plans, where principles, aims and programmes are identified along with the resources. If for some reason, a Five-Year Plan cannot be approved then interim Annual Plans bridge the gap. While new programmes and schemes are introduced and existing ones modified to suit the objectives of the Plan, some, however, are of an essential nature and continue in succeeding plans. One such example is the Public Distribution System. The Plans adopted so far since Independence and the priority areas under each are shown in table 1.1.

182. The Ninth Plan (1997–2002) was launched in the 50th year of India’s Independence. The provision of basic minimum services of safe drinking water, primary health care facilities, universal primary education, shelter and connectivity in a time-bound manner is a specific objective of the Ninth Plan. Within the social sector, planning in India has ensured that appropriate policy and programme initiatives are taken and adequate investment is provided by the State so that the poorer and vulnerable segments of the population can access essential facilities, services and commodities based on their needs.

183. The Ninth Plan outlay has increased by 30.67 per cent, as compared to the Eighth Plan outlay (see figure 1.1). When comparing the percentage share of various sectors, the share of agriculture, rural development, irrigation and flood control, social services and general services in the total plan outlay has decreased in the Ninth Plan in relation to the Eighth Plan, reflecting a higher priority for infrastructure, energy and industry.

184. The development of children as an investment in the country’s human resource development has been the major strategy in the Ninth Plan. Special emphasis is being placed on the girl child and on reaching infants below the age of two years. Towards this, the nationwide ICDS will continue as the major intervention for the overall development of children. A scheme called the Balika Samriddhi Yojana (BSY) was launched in October 1997 for raising the status of the girl child. Education has also been given a high priority in the Ninth Plan with a focus on providing universal elementary education and on quality improvement at the secondary and higher education levels. Along with the identification of new, existing and modified programmes to achieve the primary objective of each Plan, financial resources are also allocated. This includes the funds disbursed by the GOI in the form of Plan and non-Plan funds. Additionally, States and UTs raise resources by way of municipal taxes, cess, etc. A statement giving the details of the GOI (Central) budget from 1995 is as shown in table 1.2.

Table 1.1: Plans and priority areas
Plan
Year
Priority
First Plan
1951-56
To promote agriculture, including irrigation.
Second
1956-57 to 1960-61
To promote a pattern of development which would ultimately lead to the establishment of a socialistic pattern of society.
Third
1961-62 to 1965-66
To secure a marked advance towards securing self-sustaining growth.
Annual
1966, 1967, 1968

Fourth
1969-1974
To accelerate the tempo of development and to raise the standard of living through programmes designed to promote equality and social justice.
Fifth
1974-79
To achieve self-reliance and adopt measures for raising the consumption standard of people living below the poverty line.
Sixth
1980-85
To remove poverty, and simultaneously move towards strengthening infrastructure for both agriculture and industry.
Seventh
1985-90
To emphasise growth in food-grains production, increased employment opportunities and productivity within the framework of self-reliance and
social justice.
Annual
1990-91 to 1991-92

Eighth
1992-97
To balance the initiation of structural adjustment policies. It recognised “human development” as the core of all development efforts.

Source: Planning Commission.

185. Recent budgets have been formulated in the backdrop of the super cyclone in Orissa, the devastating earthquake in Gujarat, a somewhat weak monsoon, hike in international petroleum prices and continued uncertainties in world economic recovery. These events have led to unanticipated expenditures on disaster relief and imports. In spite of these adversities, GOI has tried to keep the fiscal deficit under check, so that social sector expenditures will not be eroded by inflationary pressures. The Centre’s gross fiscal deficit has been in the range of 5–5.5 per cent in recent years. The Fiscal Responsibility and Budget Management Bill, 2000, has been introduced to bring down the fiscal deficit and contain the growth of public debt.

Figure 1.1: Comparison of Eighth and Ninth Five-Year Plan outlays

G034386901.jpg

Source: Planning Commission

186. The Planning Commission of India, a high-level body chaired by the Prime Minister, is responsible for overseeing the planning process and for finalising the plans. The Planning Commission also evaluates the schemes to assess their physical and financial performance, the efficacy of the implementation/delivery mechanisms and impact on the beneficiaries. The findings of the evaluation studies are used as a feedback for mid-course corrections in design and implementation, passed on to researchers and the general public through publications, seminars and the print media for generating informed debate on the nature and efficiency of public spending.

187. Some significant programmes and schemes, which were uniquely designed and launched keeping in mind the objective of the Ninth Plan, are the Prime Minister’s Rural Roads Project and the Balika Samriddhi Yojana. Existing initiatives which have been restructured or merged include, among others, the Swarnajayanti Gram Swarozgar Yojana (SGSY) which seeks to provide sustainable incomes through micro-enterprises to the rural poor.

188. In India, special attention has been paid to the requirements of the weaker sections. The Constitution has specific clauses for the Scheduled Castes (SCs) and Scheduled Tribes (STs), to ensure their social, economic and political equality. Special provisions have been made for the advancement of SCs and STs in the planning process, in the allocation of resources, in educational institutions, in appointments to jobs and in promotions, amongst others. Due consideration is also given in the planning process to areas which face a disadvantage on account of their geographical location or difficult topography, e.g. the States and UTs in the North-East of India.

Table 1.2: Government of India budget
(per cent of GDP)

1995–96
1996–97
1997–98
1998–99
1999–2000
(R.E.)
2000–2001
(BE)
1. Revenue Receipts
9.3
9.2
8.8
8.5
9.3
9.3
2. Capital Receipts
4.1
3.7
5.4
6.1
6.1
6.2
3. Revenue Expenditure
11.8
11.6
11.8
12.4
12.8
12.9
4. Capital Expenditure
2.4
2.3
2.4
2.2
2.5
2.6
5. Total Expenditure (3+4)
14.2
13.9
14.2
14.6
15.3
15.5
6. Plan Expenditure
3.9
3.9
3.9
3.8
3.8
4.0
7. Revenue Exp. of which
11.8
11.6
11.8
12.4
12.8
12.9
a) Interest Payments
4.2
4.3
4.3
4.4
4.7
4.6
b) Defence Expenditure
1.6
1.5
1.7
1.7
1.8
1.9
c) Major Subsidies
1.1
1.0
1.2
1.2
1.2
1.0
8. Revenue Deficit
2.4
2.4
3.1
3.9
3.5
3.6
9. Fiscal Deficit
4.1
4.1
4.8
5.1
5.5
5.1
10. Primary Deficit
0.0
-0.2
0.5
0.7
0.8
0.5

Source: Indian Economic Survey, 2000–01, page 35

189. The Eleventh Finance Commission has made some changes in the criteria for allocation of Central Government revenues to the States. The Commission has increased the weightage given to the income disadvantage of a State (measured by the gap between a State’s per capita income and that of the richest States). At present, a weightage of 62.5 per cent is given to the income disadvantage criteria.

190. The business of the Government is conducted by Ministries and Departments both at the Central level and at the level of States and UTs, e.g. the DWCD in the GOI and the DWCD in the State of Uttar Pradesh. The GOI has exclusive powers to legislate in areas specified in List I of the Constitution, while States have exclusive powers on subjects in List II. Both have joint responsibility, or concurrent powers, for subjects falling within the purview of List III. It is seen in practice that both the GOI and the States have joint responsibility for the social sector with the GOI either directly implementing certain schemes, or passing on funds to States/UTs for the purpose. Additionally, States/UTs conceptualise and implement their own schemes from their own funds, e.g., the Apni Beti Apna Dhan (My Daughter, My Wealth) scheme in Haryana.

Budget trends in the social sector

191. The GOI’s Plan and non-Plan expenditure on various components of social sectors has increased from Rs 158.94 billion in 1997–98 to Rs 258.73 billion in 2000–2001, an increase of about 63 per cent. As a proportion of total expenditure, the combined Plan and non-Plan social sector expenditure of the Centre has been in the range of 11 per cent. As a percentage of the GDP at current market prices, expenditure of the GOI on social services has been in the range of 1.61.7 per cent. Thus, in spite of severe budgetary pressures, the Government has attempted to maintain the allocation for the social sector.

192. The GOI expenditure (Plan and non-Plan) on social sectors (education, health and family welfare, water supply, sanitation, housing, rural development, social welfare, nutrition and minimum basic services) as a ratio of total expenditure has marginally decreased from 11.26 per cent in 1997–98 to 10.72 per cent in 2000–01 (Budgeted Estimates). However, as a ratio to GDP at current market prices, the Government expenditure on social services increased from 1.59 per cent in 1997–98 to 1.66 per cent in 2000 (BE).14 For details please see table 1.3.

193. The Central Plan outlay on major schemes of social sectors as a percentage to the GDP at current market prices increased from 1.09 per cent in 1993–94 to 1.12 per cent in 1999–2000 (BE). The Central outlay increased by 29.6 per cent in family welfare in 1999–2000 (BE) over 1998–99 (RE), health by 24.3 per cent, welfare of weaker sections by 22.1 per cent and women and child development by 16.4 per cent. Educational expenditure increased from Rs 1.1 billion in 1950-51 (1.2% of GNP) to Rs 412 billion in 1997–98, (3.6% of GNP) indicating a staggering 360 times increase in 27 years. The expenditure per pupil during this period increased by 63 times. The share of GNP allocated for the development of education is a reliable indicator for assessing the relative importance given to it in a country.

Figure 1.2: Central Government expenditure on social services

(Plan and Non plan)

G034386902.jpg

194. As a percentage to the GDP at current market prices, plan expenditure of the Centre on major schemes of the social sector has been in the range of 1.1 per cent to 1.2 per cent in recent years. However, significant increases in Central Plan outlays are observed in Education, especially Elementary Education, Health, Women and Child Development, and Family Welfare programmes in the budgeted estimates of 2000–01.

195. A number of schemes and programmes of the Government have been introduced exclusively for children. An example in this regard is the Balika Samriddhi Yojana, a laudable initiative to enhance the status of the girl child. Other schemes and programmes target both children and some adults as beneficiaries, such as the ICDS which covers children, pregnant women, and lactating mothers. However, a large bulk of the Government’s scheme and programmes benefit all members of the community, including children. An instance in this regard is the provision of clean drinking water and sanitation facilities. Under these circumstances, it is somewhat difficult to identify the amounts spent on children alone. Regarding the best interests of the child, it is an undisputed and acceptable fact that the Government will always keep the best interests of the child at the forefront when formulating policies and taking decisions. The Government, at the national, regional or local level, will not deliberately or consciously take any step which goes against the child. This is also further ensured by the detailed process and extensive consultations which are part and parcel of the Government machinery. While the utmost priority is given to children in policy making, there is a need for advocating a greater resource allocation for children.

Table 1.3: Central government expenditure (plan and non-plan) on social services
(Rs in million)
Item
199697
1997–98
1998–99
1999–2000 (BE)
2000–2001
(BE)
1. SOCIAL SERVICES
136590
158940
197290
237270
258730
  1. Education, Sports & Youth Affairs
39880
50120
65500
71150
84160
b. Health and Family Welfare
27510
31740
39150
51100
58600
  1. Water Supply, Sanitation, Housing and Urban Dev.
29570
33040
41900
46190
50870
d. Information & Broadcasting
5930
8980
10740
12300
13680
  1. Welfare of SC/ST and other Backward Classes
8330
7250
9460
10830
12770
  1. Labour, Employment and Labour Welfare
5870
5620
7580
8680
94*
g. Social Welfare & Nutrition
19500
22190
22950
37020
29350
2. RURAL DEVELOPMENT
50810
55830
54030
51850
53970
3. BASIC MINIMUM SERVICES (BMS) * INCLUDING SLUM DEVELOPMENT
24660
28730
36840
40480
4. PRADHAN MANTRI GRAMODYA YOJANA (PMGY) @
50000
5. SOCIAL SERVICES, RURAL DEV. BMS & PMGY AS A PERCENTAGE OF TOTAL EXPENDITURE **
212060
243500
288160
329600
362700
6. TOTAL CENTRAL GOVERNMENT EXPENDITURE AS PER CENT OF GDP AT CURRENT MARKET PRICES **
13.9
14.2
14.6
15.5
15.5
7. SOCIAL SERVICES, RURAL DEV. BMS & PMGY AS A PERCENTAGE OF TOTAL EXPENDITURE **
11.44
11.26
11.24
10.85
10.72
8. SOCIAL SERVICES, RURAL DEV. BMS & PMGY AS A PERCENTAGE OF GDP AT MKT. PRICE $
1.55
1.59
1.60
1.68
1.66

Note : Figures for the years 1992–93 to 1998–99 are actuals
* : Came into operation from 1996-97
@ : Launched in 2000–2001 (BE) as a new initiative for basic rural needs
** : The total Central Govt. expenditure excludes the transfer of State’s/UTs share of small saving collections

$ : Ratios to GDP are at current market prices (Base : 1993–94) released by CSO, GDP for 2000–2001 are based on CSO’s Advance Estimated
Source: Indian Economic Survey 2000–2001However, significant increases in Central Plan outlays are observed in Education, especially Elementary Education, Health, Women and Child Development, and Family Welfare programmes in the budgeted estimates of 2000–01.

Regional disparities

196. Balanced development with an emphasis on the reduction of disparities in economic and social development across regions in India has been a major objective of the planning process since Independence. Apart from large investments, various public policies directed at increasing the pace of development in the weaker regions have been pursued. The relevance of this approach is highlighted when some of the key disparities between States in India are examined. For example, while India now has the world’s second largest population, five States alone comprised 44 per cent of the population in 1996, and will constitute 48 per cent of the total population in 2016. In other words, these five States, viz., Bihar, Madhya Pradesh, Rajasthan, Uttar Pradesh and Orissa will contribute 55 per cent of the population growth till 2016 and it is their performance which will determine the year and the population at which the country achieves replacement level of fertility. Also, the rates for literacy swing from as high as 93 per cent in Kerala and 95 per cent in Mizoram to 49 per cent in Bihar. Geographically, the States in South India, viz., Kerala, Tamil Nadu, Karnataka and Andhra Pradesh do far better in terms of social development. An analysis of the nature of backward regions indicates the probable causes underlying their backwardness. For example, a major cause of backwardness of certain regions in Bihar and Orissa can be associated with the distinct style of living of the inhabitants of such regions who are tribals. The topography of a region also constrains development such as in the desert region of Rajasthan. The acute scarcity of water has been identified as a primary cause of backwardness in areas such as Telengana in Andhra Pradesh. Recognising the need to address these disparities, a number of Special Area Programmes and initiatives have been introduced for the development of backward regions. These are:

(a) The Hill Area Development Programme: The main objective of this programme is to ensure ecologically sustainable socio-economic development of hill areas, keeping in view the basic needs of the people. The areas covered under this programme:

(b) Western Ghats Development (WGD) Programme: The Western Ghats Hill Ranges run to a length of about 1600 km—more or less parallel to the west coast of India. The main problems of this region are the pressure of increasing population on land and vegetation, and undesirable agricultural practices which have led to ecological and environmental problems in the region. The fragile ecosystem of the hills has come under severe pressure because of large areas under river valley projects, denudation of forests and adverse effects of floods, amongst others. The WGD Programme was launched to help the areas in dealing with these problems.

(c) Border Area Development Programme: This Programme was started in 1986–87 for the balanced development of border areas of States bordering Pakistan, viz., Jammu & Kashmir, Punjab, Gujarat and Rajasthan. During the Eighth and Ninth Plans, the programme was enlarged to cover the States bordering Bangladesh, Myanmar, Bhutan, Nepal and China. The main objective of the programme is to meet the special needs of the people living in remote, and inaccessible areas situated near the border.

Particular emphasis is being given to the improvement and strengthening of the social and physical infrastructure of these areas.

(d) North-Eastern Council (NEC): The NEC was set up in 1972 for ensuring a balanced and co-ordinated development of the North-Eastern States, viz., Assam, Manipur, Meghalaya, Mizoram, Nagaland, Arunachal Pradesh and Tripura. The NEC is an advisory body to discuss matters of common interest to the Centre and the North-Eastern States, formulate a unified and coordinated regional plan (in addition to the State Plan) and review the implementation of projects and schemes included in the regional plan.

Table 1.4: Central plan outlay for major schemes of social and rural development
(Rs in million)
Ministry/Department/Scheme
1997–98
1998–99
1999–2000 (BE)
2000–2001 (BE)
  1. Education
(a) Elementary Education
(b) Adult Education
33500
40450
43850
54490
22650
27410
28520
36090
810
770
790
1200
2. Health
9180
9810
10620
13780
3. Family Welfare
18290
22530
31200
35200
4. Women and Child Development
Integrated Child Development Services
10260
11340
12500
14600
6000
7680
8560
9350
5. Welfare
(Social Justice and Empowerment)
8040
11470
11590
13500
6. Rural Development and Rural Employment & Poverty Alleviation #
82900
93450
93510
97600
(a) Jawahar Gram Samriddhi Yojana (JGSY)*
(b) Employment Assurance Scheme (EAS)
(c) National Social Assistance Programme
(d) IRDP (Swaranjayanti Gram Swarozgar Yojana)**
(e) Rural Water Supply and Sanitation
(f) Rural Housing (including Indira Awas Yojana)++
19530
20600
16890
16500
19050
19900
20400
13000
4900
6400
7100
7150
5520
7010
9500
10000
14020
16690
18990
22400
11440
15320
16590
17100
7. Other Programmes e.g.
(a) Nehru Rozgar
(b) Prime Minister’s Rozgar Yojana (NRY) Yojana (PMRY)
(c) Swaranajayanti Shahari Rozgar Upkarna @@
310
950
1030
1360
1620
1900
1260
2010
1680
A. Total Central Plan outlay on Major Schemes on Social Sectors (1–7)
16440
192030
106430
232860
B. Total Plan Expenditure
606300
683710
793950
881000
C. As percentage of Total Plan Expenditure
27.13
28.09
26.00
26.43
D. GDP at current market prices (Rs crore)
15224410
1758276
19569970
217939910
E. As percentage of GDP at current market prices $
1.08
1.09
1.05
1.08

# From 1999–2000, it includes allocation for three departments viz. Rural Development, Land Resources and Drinking Water Supply

* Jawahar Rozgar Yojana was restructured and renamed as Jawahar Gram Samriddhi Yojana (JGSY) from April 1999

** IRDP has been renamed as Swarnajayanti Gram Samriddhi Yojana (JGSY) from April 1999 and its allied programmes like TRYSEM, DWCRA, SITRA, GKY and MWS merged with it

++ The Indira Awas Yojana (IAY), earlier a sub scheme of JRY has become a separate scheme from 1.1.1996

@@ Is a rationalised version of the erstwhile schemes of Urban Basic Services, NRY and PM’s Integrated Urban Poverty Eradication Programme

$ Ratios to GDP or at current market prices (base: 1993–94) released by the Central Statistical Organisation (CSO). Advance Estimates.

Source: Indian Economic Survey, 2000–2001

SECTION II

DEFINITION OF THE CHILD

Article 1

197. Article 1 defines the holder of rights under the CRC as “every human being below the age of 18 years unless under the law applicable to the child, majority is attained earlier.” The Convention clearly specifies the upper age limit for childhood as 18 years, but recognises that majority may be obtained at an earlier age under laws applicable to the child. The article, thus, accommodates the concept of an advancement of majority at an earlier age, either according to the federal or State laws of a country, or personal laws within that country. However, the upper limit on childhood is specified as an age of ‘childhood’ rather than “majority”, recognizing that in most legal systems, a child can acquire full legal capacity with regard to various matters at different ages.1

198. Thus, while the Convention defines a “child” as every human being below the age of 18 years, it allows for minimum ages to be set, under different circumstances, balancing the evolving capacities of the child with the State’s obligation to provide special protection. Accordingly, Indian legislation has minimum ages defined under various laws related to the protection of child rights.2

199. Though legislation has been enacted to make 18 years the general age of majority in India, 21 years continues to be the upper limit for childhood for some purposes, partly due to the influence of nineteenth-century English Law and partly due to current exigencies.3 For example, India recognizes 21 years as the age of majority in circumstances where a guardian has been appointed by the Court for a child below the age of 18 years.4

200. With respect to the rights of the child in the womb, the legislation in India is in harmony with the interpretation of the Convention. The articulation of the “right to life” in the Indian Constitution reflects the English Common Law approach, in that it states that this right is conferred on a “person”. Although India has permitted medical termination of pregnancy through legislation enacted in 1971, this recourse can be taken only in the following cases: (a) the continuance of pregnancy would involve a risk to the life of the pregnant woman or a grave injury to her physical and mental health or (b) there is substantial risk that if the child is born, it would suffer from such physical or mental abnormalities that it would be seriously handicapped. Significantly, section 20 of the Indian Succession Act gives the right to property to a child in the womb whose parent dies intestate and who is subsequently born alive—he/she will have the same right to inherit as if he or she had been born before the death of the parent.5

201. Varying ages of legal capacity is a phenomenon that can be seen in many countries. However, while the CRC’s definition of childhood can be perceived as setting a basic minimum standard in view of article 41, which declares that “nothing in the Convention or any of its provisions shall effect realisation of the rights of the child” under the law of a State Party, it is essential that there is some synchronisation of the upper age limit for childhood. India has achieved this to a large extent, for instance, the minimum compulsory age of education is 14 years. The various laws relating to labour prohibit a person under the age of 14 years to work. Thus, the minimum age at which compulsory education ends synchronises with the minimum age of employment.6 The age of capacity to contract a marriage is 18 years for a girl and 21 years for a boy, for all communities. The Child Marriage Restraint Act, 1929, defines a child as a person who, if a male, has not completed 21 years of age, and if a female, has not completed 18 years of age. Under Section 5 of this Act whoever performs, conducts or directs any child marriage shall be punishable with simple imprisonment upto three months and shall also be liable to fine, unless he proves that he had reason to believe that the marriage was not a child marriage.7 This uniform legislation is an effort to discourage child marriages under personal laws.8

202. However, regarding certain aspects that are deeply rooted in the community, and compounded by historical poverty and vulnerable socio-economic conditions, there is a gap between laws and their enforcement. For example, child labour is a fact that exists in our country, and in spite of our consistent efforts, child marriages are still prevalent. The Government has already initiated action to review and amend the laws pertaining to rape and sexual consent, so as to remove any discrepancy between girls and boys.

Table 2.1: Minimum legal age defined by national legislation

Age (years)

Boys
Girls
End of compulsory education*
14
14
Marriage*
21
18
Sexual consent**
Not defined
16
(Section 375 of the Indian Penal Code)
Voluntary enlistment in the armed forces*
16
(A person is allowed to take part in active combat only at the age of 18)
Conscription into the armed forces India.
There is no conscription in India.
There is no conscription in India.
Participation in hostilities
Not applicable
Not applicable
Admission to employment or work,including hazardous work, part-time and full-time work*
  • Child Labour (Prohibition and
    Regulation) Act, 1986
  • Mines Act, 1952
  • Merchant Shipping Act, 1958
  • Motor Transport Workers Act, 1961
  • Apprentices Act, 1961
  • Bidi and Cigar Workers Act, 1966
  • Plantation Labour Act, 1951
  • Factories Act, 1948
14
18
14
14
14
14
14
14
14
18
14
14
14
14
14
14
Criminal responsibility*
12
(Section 83 of the Indian Penal Code, according to which, nothing is an offence which is done by a child above seven years of age and under 12 years, who has not attained sufficient maturity of understanding to
judge the nature and consequences of his conduct on that occasion. It may be noted that children below the age of seven years are deemed to be incapable of criminal offence as per section 82 of the Indian Penal Code)
Juvenile crime
18
The Juvenile Justice and Protection of Children) Act, 2000.
Deprivation of liberty, including by arrest, detention and imprisonment, interalia in the areas of administration of justice, asylum-seeking and placement of children in welfare and health institutions*
There is no age limit for deprivation of liberty because as per Article 21 of the Constitution of India, all citizens have protection to life and personal liberty.

Boys
Girls
Capital punishment and life imprisonment* Giving testimony in court, in civil and criminal cases*
18
Section 118 of the Indian Evidence Act states that all persons shall be competent to testify unless the court considers that they are prevented from understanding the question put to them or from giving rational answers to those questions by virtue of tender years, extreme old age, disease, whether of body or mind or any other cause of the same kind. Therefore all persons irrespective of their age are competent to testify in court provided the adult or child understands the question.
Lodging complaints and seeking redress before a court or other relevant authority without parental consent*
There is no minimum age prescribed for lodging complaints and seeking grievance before a court or other relevant authority without parental responsibility.
Participating in administrative and judicial proceedings affecting the child*
As mentioned above.
As mentioned above.
Giving consent to change identity, including change of name, modification adoption, guardianship*
18
For modification of family relations, adoption, and guardianship, there is no minimum age prescribed.
Having access to information concerning the biological family
Not defined.
Not defined.
Legal capacity to inherit
According to Section 20 of the Hindu Succession Act, even a child in the womb has the right to inherit property and it shall be deemed to from the date of death of one who died intestate. However, as per Section 4 of the Hindu Minority and Guardianship act, 1956, the guardian will have the powers to take care of the property of such a minor.
To conduct property transactions
21
Section 11 of the Indian Contract Act, 1972, states that a person is competent to contract only if he/she is a major and is of sound mind.
To create or join association
Not defined.
Not defined.
Choosing a religion or attending
religious school teachings
Not defined.
Not defined.
Consumption of alcohol and other
controlled substances**
21
21

Source: *NI/PC/SAP/132/2000/908 dated July 31, 2000, National Institute for Public Cooperation and Child Development, Government of

India (GOI)

** Responses to the List of Issues raised by the UN Committee on the Convention on the Rights of the Child, Department of Women and Child Development, GOI

*** Child and Law, Indian Council for Child Welfare, Chennai, Tamil Nadu, page 507

SECTION III
GENERAL PRINCIPLES
A. Best Interests of the Child
Article 3

203. Article 3 (1) of the CRC requires the legislature, the executive, the major agencies of government, courts of law and private social welfare institutions within a country to make the ‘best interests of the child’ a primary consideration in their action and decisions. Almost 40 years before the CRC, the Constitution of India adopted a similar view towards children and incorporated many provisions to ensure their best interests:

204. The principle of upholding the best interests of the child is not only reflected in the Constitution of India but also in the National Policy for Children, the National Plan of Action for Children (1992), the proposed National Charter for Children and the terms of reference of the proposed National Commission for Children, as well as in other schemes and programmes related to children.2
Legislative measures

205. The best interests principle is reflected in national legislation in relation to decision making about individual children, for example, in proceedings of divorce or separation, in adoption and in State intervention to protect children from abuse. This principle is also echoed in legislation and programmes covering large groups of children and their families, such as various poverty-alleviation programmes, distribution of low-cost essential commodities through the public distribution system, employment-generation programmes for the poor, low-cost housing schemes for the poor and free education for children belonging to the disadvantaged sections of society. The concept of the child’s ‘best interests’ has been used in guardianship litigation in India to take into account the child’s wishes and preferences in a context where the child is mature enough to express a considered opinion on a matter concerning his or her life. The Guardianship and Wards Act provides guidelines for deciding what is best for the child, giving consideration to age. The focus on the child’s ‘best interests’ contributed to the introduction of the paramountcy of the ‘best interests of the child’ concept into the codified Hindu Law in 1956. The concept provides for decision making by Juvenile Welfare Boards in a child-centred environment. This Act has many innovative features such as limiting access to lawyers and limiting the time for enquiries, all of which ensure that the child’s interests are safeguarded.
Judicial interpretation

206. The Supreme Court of India has developed the concept of social interest litigation to enforce the Fundamental Rights and give strength to the Directive Principles of State Policy. It is of interest that several leading cases of social interest litigation concern the rights of children either because they impact on children or have been brought specifically before the courts to address infringements of the rights of children guaranteed by the Constitution. Social interest litigation thus represents a vital opportunity to realize ’best interests’ of the child in an environment of cooperation between the Government, the courts, and non-governmental and private agencies concerned with children. Judicial activism is also a strategy for promoting State accountability and compelling action. Since the superior court has the power of judicial review, it can challenge legislation as well as administrative action or inaction for infringement of Constitutional guarantees. This creates an environment in which international standards on developing a consensus on safeguarding the child’s interests can be linked with the Constitutional law developments.

207. For instance, in two recent cases of social interest litigation initiated in the Supreme Court, on the basis of concern for the situation of children of prostitutes, the court took judicial notice of their situation and appointed committees to study and report on this problem. In one of these cases, the court refused to give an order requiring the GOI to make provisions for separate schools with vocational training facilities and separate hostel for children of prostitutes. The court declared that such policies of “segregation” would not be in the “best interests” of these children, and that they must be brought up to “mingle with others and become part of society”. Other notable examples of judicial activism have been dealt with in the report in different sections.

Box 3.1: High court upholds ‘best interests of the child’
The Rajasthan High Court has allowed nine-year-old Ankit to live with his mother, Seema, in Rajasthan, holding the decree of a foreign court granting custody to his father, Allan Davinder Walia, as illegal.
The High Court relied on the theory that the welfare of the child would be best served by his mother. The High Court said that “We think that it will be in the best interest of the minor to allow him to continue with his mother.”

Source: The Times of India, January 2, 2001 Policies and programmes

208 Wherever policies and schemes are being framed, the Government collects inputs from an array of sources. In addition to inputs generated by the Government’s own machinery at all levels, interaction with NGOs on specific issues also leads to the best interests of the children being seriously considered before a final decision is taken. In the democratic set-up that exists in India, a number of suggestions are received through people’s representatives such as members of Parliament and members of Legislative Assemblies. Many child-related issues like children’s education and working conditions have been brought to the notice of the Government through this route. These processes, the Government feels, contribute to ensuring that the best interests of the child are kept in view while formulating policies and schemes. Side by side, NGOs have drawn specific attention to the absence of child rights in the agenda of political parties. They also feel that much remains to be done by way of introducing appropriate legal measures, as well as taking steps to ensure that these are effectively implemented. According to NGOs, the administration may need to be equipped better for promoting children’s rights. In addition, concerned officials should be sensitized to issues related to children.3

209. The bests interests of the child in family life are reflected in the National Policy for Children, which, inter alia, stresses the need to strengthen family ties so that the child’s full potential could be realised within the normal family, neighbourhood, and community environment.4

210. The best interests of the child have also been ensured through the Central Adoption Resource Agency (CARA), which has been set up under the Ministry of Social Justice and Empowerment for looking after the best interests of the child as well as to function as a clearing house of information regarding adoption of children. Apart from this, voluntary coordinating agencies in almost all States have been set up in association with NGOs to promote the best interests of the child through adoption. The issue has been dealt with in detail under the section on adoption. The Juvenile Justice (Care and Protection of Children) Act, 2000, provides for the treatment, development and rehabilitation of neglected or delinquent juveniles and for the adjudication of certain matters related to and disposition of delinquents.5 The administration of this Act has been dealt with in detail under the section on Administration of Juvenile Justice. The Ministry of Social Justice and Empowerment has undertaken programmes for the care and rehabilitation of abandoned, neglected, orphaned and homeless children. The welfare services being provided under the scheme include food, shelter, education, health, and vocational training. The programme has been dealt with in detail under the section on Separation from Parents. Social security for children in India, however, is not a separate entity, although the GOI has launched various programmes and activities which provide child care services and facilities so as to prevent child abuse and neglect. (For further details please refer to the section on Social Security).

211. The principle of “best interests of the child” is given due consideration while adopting budgets, policies and programmes at the State and local levels. Budgets for specific sectors are decided at the State level through an elaborate procedure which involves the departments concerned submitting their proposals for provisions in specific sectors that directly affect child welfare. The Finance Department, in consultation with the department concerned, processes these proposals. Understandably, the finalisation of the budget is mainly based on the available resources and the priorities of the Government. It is hoped that as more awareness about this principle is generated, the preparation of proposals will generate greater resources and accord primacy to the best interests of the child.

212. According to NGOs, awareness about what should constitute the best interests of the child is lacking among most adults who regularly interact with children or influence their lives in some way. Secondly, there is general lack of will to implement and protect the best interests of children. Some examples quoted with reference to school life were:

213. At the family level too, it is felt that children’s needs are rarely considered in family-level decisions, including those decisions that are likely to affect their lives. Older children, especially girls, are entrusted with the care of their younger siblings, and as a result are deprived of the opportunity and right to education.6
Standards for public and private institutions

214. In order to establish appropriate standards for all public and private institutions concerned with services and facilities responsible for the care and protection of children, minimum standards in child care were first evolved by the Indian Council for Social Welfare in 1954. Thereafter, in 1959, the Central Social Welfare Board set up a committee on the grants-in-aid code, which examined the advisability of defining minimum standards for various social services for children and women. Accordingly, in various legislations such as the Suppression of Immoral Traffic in Women and Girls Act, 1956, and Probation of Offenders Act, 1958, provisions relating to the maintenance of minimum standards in institutions set up for women and children have been spelled out.

215. The Model Rules under the Juvenile Justice Act, 1986, provided that each child care institution should have the necessary staff and ensure that (a) regular treatment is available for the medical treatment of the children, (b) arrangements are made for immunisation coverage, and (c) a system is evolved for the removal of serious cases to the nearest civil hospitals or treatment centres. These rules further provided that immediate action should be taken in respect of an inmate who is suffering from leprosy or is of unsound mind or is addicted to a drug. The Model Rules also elaborate that each State Government should prepare a diet for children in consultation with nutrition experts so that their diet is balanced, nutritious, wholesome and varied. As regards clothing, bedding and other articles, these should be provided to each child in accordance with the norms prescribed by State Governments.

216. To ensure compliance with rules and procedures, the State Governments provide for necessary staff for inspection. For example, the Chief Inspector, Inspector and Assistant Inspector during the course of an inspection is expected to give every child an opportunity to make any complaint. The Model Rules also exemplify that the State Government shall provide for the training personnel for each category of staff in keeping with their statutory responsibilities and specific job requirements.7 [Model Rules under the Juvenile Justice (Care and Protection of Children) Act, 2000, are currently under preparation].

217. There are mechanisms for establishing and maintaining standards in private and public nstitutions that deal with the care and protection of children, in matters of the institutions themselves, their services and their facilities. Institutions receiving grant-in-aid from the Government have to conform to the grant-in-aid code of the Government. All assisted institutions are subject to inspections by Government departments. In addition to regular inspections, surprise inspections are also carried out in case of specific complaints or on a random basis. In case such inspections lead to the detection of serious irregularities, the recognition of the institution by the Government is cancelled. If the irregularity is not very serious, the institution concerned is asked to comply with the specified requirements and may have its grant cut. These steps ensure that institutions supported financially by the Government for the purpose of child care and protection conform to the objectives and priorities of the Government.8

218. While promoting the principle of the best interests of the child, the GOI is currently focusing on issues related to the promotion of a child rights based approach and participation in training of professionals dealing with child rights.9

B. Non-Discrimination

Article 2

Constitutional provisions, policies and legislation

219. The guiding principles underpinning the Constitution of India are equality before law, equal protection to all and non-discrimination. The standards set by the Constitution link to the standards set by article 2 of the CRC. Equality is a dynamic concept with many aspects and dimensions and it cannot be “cribbed, cabbined and confined” within traditional limits (E.P. Royappa vs. State of Tamil Nadu).1 Articles of the Constitution of India reflect this concept, in the interpretation of equality and non-discrimination. Article 14 of the Constitution, holds that “The State shall not deny to any person equality before law or the equal protection of law within the territory of India.” article 15 enjoins upon the State not to discriminate against any citizen on the grounds of religion, race, caste, sex or place of birth. Clauses 3 and 4 of Article 15 are exceptions to the general principles of non-discrimination. They empower the State to make special provisions for women and children, respectively, and for the advancement of any socially and educationally backward classes of citizens or for SCs/STs. Article 17 has abolished untouchability and forbidden its practice in any form. To enforce this solemn commitment, the Government passed the Untouchability (Offences) Act in 1955. It was amended in 1976 and is now known as the “Protection of Civil Rights Act, 1955”. Articles 25–28 provide to all persons guarantees of the Right to Freedom of Religion in all aspects. Article 29 of the Constitution of India guarantees to “every section of the citizens”, residing anywhere in India and “having a distinct language, script or culture”, the right to conserve the same. No citizen can be denied admission to any educational institution maintained and aided by the State on the grounds of religion, race, caste or language. Article 30 states that all minorities, whether based on religion or language, shall have the right to establish and administer educational institutions of their choice.

220. In keeping with its objective of securing social and economic justice to all, the Constitution makes certain provisions to help the weaker sections of society and to remove all biases. However, while Constitutional provisions in India refer to an individual’s right of equal admission to educational institutions, this is qualified by stating that this shall not prevent affirmative action on behalf of disadvantaged groups. Constitutional norms, therefore, justify intervention on behalf of many disadvantaged groups of children, such as girls, children belonging to SCs and STs, children born out of wedlock and disabled children, as correctional policy measures to eliminate inequality.2 The Constitution of India underlines the importance of achieving substantive rather than purely formal equality in specific areas which justify affirmative action policies on behalf of women and children. Thus, a provision on the guarantee of equality before the law and non-discrimination on specified grounds states that the article on equality shall not be construed so as to prevent “special provisions for women and children”. These constitutional provisions, thus, reflect a commitment to realizing gender equity and preventing discrimination against girl children. The standards set by the Convention, on non-discrimination against girls is already clearly articulated in the Constitution.3

Box 3.2: Measures taken to preserve tribal culture and prevent discrimination
A number of schemes are being implemented to help tribal children such as the ‘Grain Schemes’ in tribal areas through which food grains are given to tribal families to motivate them to stay in their villages or hamlets. Industries are also being set up in the tribal belts to prevent the tribal population from moving out. The Department of Education formulated a very ambitious scheme of teaching tribal children in primary classes in their own dialects. Textbooks in ‘Bhili’ and ‘Dangi’ dialects were also brought out for children studying in the primary classes. Discrimination does not exist in most rural areas since most of the time all the children studying in a particular class or school belong to the same caste or tribe. Teachers are also specially instructed to ensure that they do not discriminate between students belonging to different ethnic groups.

Source: Gujarat State Report, Government of Gujarat

221. The caste system has been a dominant feature of Indian social life for centuries. Nevertheless, several trends such as urbanisation, positive discrimination, growing literacy and economic growth have been whittling down caste barriers, particularly in urban areas. Parliament has also enacted the SCs and STs (Prevention of Atrocities) Act, 1989, as a welfare legislation, with the object of preventing atrocities against the members of Scheduled Castes and Scheduled Tribes, to provide for Special Courts for the trial of such offences and for the relief and rehabilitation of the victims of such offences and for matters connected therewith or incidental thereto. The framers of the Indian Constitution did not overlook the need to provide a separate Commission for SCs and STs. The National Commission for SCs and STs, which was reshaped in 1978, advises on broad issues on policy and levels of development of SCs and STs.4

222. There is an affirmative action policy for children of backward castes and Scheduled Tribes in Tamil Nadu and many other States for admission to higher education institutions and Government service. Programmes oriented towards their welfare are monitored through the Commission for Scheduled Castes and Tribes and Commission for the Welfare of Backward Classes, Minorities and Women.5

223. In order to prevent discrimination against the most disadvantaged groups of children, the GOI has enacted a wide range of laws and policies, all of which protect their rights. Some prominent laws are the Child Labour (Prohibition and Regulation) Act, 1986; the Immoral Traffic (Prevention) Act, 1986; the Juvenile Justice Act, 1986; and Persons with Disabilities (Equal Opportunities, Protection of Rights and Full Participation) Act, 1995. Similarly, some prominent policies enacted by the GOI are the National Policy for Children (1974), the National Policy on Education (1986) and National Policy on Child Labour (1987).6 Apart from guaranteeing equal opportunity for all under the Constitution, India also has specific laws for women. The Convention on the Elimination of All Forms of Discrimination against Women (CEDAW) has been ratified by India in 1993. The National Policy on Education, 1986, directly addresses the question of setting right the traditional gender imbalances in education and makes a strong commitment in favour of education for women’s equality.

224. To meet the challenge against discrimination against the girl child, members of the South Asian Association for Regional Cooperation (SAARC) collectively observed 1990 as the Year of the Girl Child and 1991–2000 as the SAARC Decade of the Girl Child. The GOI also developed and disseminated a National Plan of Action for the Girl Child (1991–2000) in 1992 for the “survival, protection and development of girl children”. The Plan recognized the rights of the girl child to equal opportunity to be free from hunger, illiteracy, ignorance and exploitation.7 For monitoring the implementation of the Plan of Action, an inter-ministerial Coordination Committee of Secretaries has been constituted to meet regularly and review progress. In the National Policy for the Empowerment of Women, a policy framework has been laid down for the elimination of discrimination and violation of the rights of the girl child. The Indian Penal Code and the Immoral Traffic (Prevention) Act (ITPA) make the offences of child trafficking, prostitution of children and sexually abusing them, liable for a higher punishment than the perpetration of such offences against adults. The ITPA contains a provision for presumption of guilt on the part of a person under certain circumstances when the victim is a child who has been sexually abused. The Supreme Court, in a social interest litigation, ordered the Central and State Governments to set up advisory committees for recommending measures to eradicate child prostitution. The Committee drew up a Plan of Action to Combat Trafficking and the Commercial Sexual Exploitation of Women and Children, containing action points grouped under prevention of trafficking, health services, education, awareness generation and social mobilisation, economic empowerment programmes, legal reforms and law enforcement and monitoring.

225. One of the major steps taken to prevent discrimination against disabled persons was the enactment of the Persons with Disabilities (Equal Opportunities, Protection of Rights and Full Participation) Act, 1995. The International Year of Disabled Persons (IYDP) in 1981 helped create awareness in societies that disabled persons are also a “human resource”. Several other measures have been taken up to ensure the rights of children with disabilities.8 (For details refer to section 23). However, in most situations, disabled children are judged as a group according to their disabilities and not as individuals or as children. They often do not enjoy personal or economic security, and many are victims of deprivation, pain and poverty. These children are most in need of means of survival and access to a social safety net, equal opportunities for education and development of their potential to the maximum.

226. Street children who also face discrimination in their daily lives, are categorized into three groups: (a) children on the streets who live with their families (b) children for whom the street is their home, and (c) children on streets who have no contact at all with their families. The last category includes orphans, refugees, and runaways. Government institutions run under the Juvenile Justice (Care and Protection of Children) Act, 2000, provide services for the development and rehabilitation of neglected and juvenile delinquents. Street children are covered by a mechanism called the Juvenile Justice System.9 (The issue has been dealt with in detail under the section on Administration of Juvenile Justice.)
Girl child

227. Gender is gradually becoming an integral part of all child development policy, planning, programming, monitoring, evaluation and information gathering activities.10 However, in India, the girl child still occupies a position far inferior to that of a male child. Prioritising the needs of the girl child, as deserving of special attention within the larger group of women, has been a principle guiding state action in India. In preparation for the Beijing Platform for Action 1995, India led a struggle for the inclusion of a separate chapter highlighting the importance of investing in the girl child—into the Platform for Action. This addition was significant. It implies that investments made in the first and second decades of a woman’s life will provide incremental returns and help to break the cycle of inequality and deprivation for the adult woman. The need for priority action to improve the situation of the girl child is underlined throughout the Platform for Action, which proposed a dual strategy: first, measures for mainstreaming sectoral programmes so that they reach and serve girls who are systematically discriminated against. Second, targeted programmes and advocacy initiatives designed and implemented to address specific concerns for girls. At Beijing, while accepting the Platform for Action without reservation, India made five additional commitments to improve the situation of women and girls. While all will benefit girls, the women of tomorrow, two were specifically targeted to improve the situation of girls immediately. These were an increase in the education budget to six per cent of GDP and an improvement in the development support and health care schemes for women and children.11

Box 3.3: Convention on abolition of female foeticide
The Indian Medical Association in collaboration with the National Commission for Women and UNICEF organised a Convention of national religious and political leaders on the abolition of female foeticide and infanticide on June 24, 2001 in New Delhi.
The Convention was held against the backdrop of alarming revelations by 2001 Census that the female-male sex ratio (933 to 1000) in India is the lowest in the world. The situation was even more dismal in some of the prosperous States with the sex ratio at 733 in Chandigarh, 821 in Delhi, 861 in Haryana and 864 in the Punjab.
The Convention was also historic because religious leaders representing a wide spectrum ranging from the Parsis, Bahais, Jains, Christians, Hindus and Muslims, shared a common platform to condemn the practice of female foeticide.
Led by Jagadguru Shankaracharya of Kanchi, the leaders said that they would use all their resources to propagate among the Indian masses the need to stop this heinous practice.
Speaking at the Convention, NCW Chairperson said that there was an unholy alliance between patriarchal attitude and modern technology resulting in brutal murders of girl-children in the womb. She appealed to the religious leaders, who influenced the thinking and the behaviour of their followers, to condemn this social evil.
Another speaker said that the root cause of this retrograde practice was dowry which undermined the status of a girl child and a woman in the society. He appealed for reform in religions which should be alive to the rights of women.
The Chief Minister of Delhi spoke of the urgent need to change mindsets by breaking blind beliefs in rituals. The Minister for Human Resource Development, admitted the Government’s failure to stop female foeticide despite 17 different laws against it. The Minister appealed to the religious leaders to reinterpret the scriptures according to the changing times. He felt that the opinions of the seers would have more impact on the masses than the laws. The Minister of State, Department of Women and Child Development, wished that women were treated neither as godesses nor as slaves; let them be accepted as human beings, she pleaded.
The IMA secretary, reiterated the Association’s decision to ostracise doctors doing diagnostic tests to determine the sex of a child or conducting abortion of a female foetus.
The National Commission for Women appeals to all members of the society to respond to the need of the hour and rise to the occasion to give an unborn girl child a future to look forward to.

Source: Rashtra Mahila, June 2001

228. Hwever, while all rights apply to all children without exception, many girl children are systematically denied their rights from the day they are born. A girl child’s experience of discrimination begins at home. Girls are often malnourished because mothers tend to breastfeed their daughters for a shorter period of time than their sons; girls are generally the last ones to eat a meal in the family and when nutritious protein is available it is usually given to the sons. Families do not often seek medical care for their daughters until the illness has progressed, and even then girls are rarely taken to the hospital— as a last resort, families often only consult the traditional healer to help cure a girl’s illnesses. More than half of India’s girl children do not go to school— and if a girl does go to school, she is likely to drop out before she is 12 years old. The negative bias against the girl child is also reflected in the widespread use of sex determination tests and prevalance of female foeticide/infanticide. This issue has been dealt with in detail in the next section.

229. An area of concern is India’s unfavourable sex ratio, which is primarily due to a higher female mortality rate as compared to the male mortality rate right upto the age of 35 years. Every year, about 12 million girls are born in India; three million, or 25 per cent, do not survive to see their fifteenth birthday; a third of these deaths take place in the first year of life. Thirteen per cent of female deaths before the age of 24 years are due to complications in pregnancy and childbirth. Though the expectancy of life at birth has improved over the years and the mortality for all ages has declined sharply, major gains in female life expectancy have accrued mainly to the older age group.

230. The attitudes towards girls are reflected in the following social trends.

  1. Population growth indicates gender discrimination—during 1981–91, the female population (21.77 per cent) grew at a slower pace than the male population
    (22.40 per cent);
  2. Sex ratio is unfavourable to women— from 972:1000 in 1901 it has come down to 933:1000 in 2001. Without discrimination the ratio should be approximately 1050/1000. As per the 1991 census there were approximately 13.34 million girls (019 years) missing in India;
  3. Girl child marriage—despite steady increase in average marriage age in India, child marriage is still common in rural society. Thirty-nine per cent of girls between 1519 years were married during 1992–93. Early marriage and early pregnancy results in physical wastage, birth complication and low-birth weight babies with poor survival rates;
  4. Early pregnancy and unsafe motherhood—17 per cent of total births are from mothers in the age group 15–19 years. Early pregnancy damages the health of both the mother and the child and puts both lives at risk. The maternal mortality rate in India is high at 437/1 00,000 births. It is estimated that 13 per cent of these deaths occur before the age of 24 years;
  5. Female mortality—although, overall mortality rates have declined, high female mortality persists at every age level up to the age of 35 years. Differential health care, education, nutritional status, and existing cultural beliefs and practices are to blame for higher female mortality;
  6. Every year 12 million girls are born—three million of whom do not survive to see their fifteenth birthday. About one third of these deaths occur in the first year of life and it is estimated that every sixth female death is directly due to gender discrimination. Son preference results in female foeticide, infanticide and neglect. Foeticide, although largely invisible, is commonly practised in Maharashtra, Rajasthan, Tamil Nadu, Haryana and Punjab;
  7. Nutritional status—the root cause of malnutrition amongst girls is as much poverty and lack of nutritious food, as lack of value attached to girls. Discriminatory feeding practices reveal:

231. Gender discrimination results in malnutrition of girls on a large scale, with 45 per cent of India’s girls suffering from stunted growth as opposed to 20 per cent of boys. Due to dietary deficiencies, adolescent girls do not achieve their potential weight and height. Also, 35 per cent of rural adolescent girls have a weight below 38 kg and a height below 145 cm. Additionally, adolescent girls are highly susceptible to anaemia, which is often responsible for miscarriages, still births, premature births, low birth-weight babies and maternal mortality during childbirth. Undernourished girls who grow into undernourished mothers continue a vicious intergenerational cycle of under-nutrition and wastage of women.

232. Girls work at home. Their work is invisible because it is located in the domestic sphere—this invisibility apportions a secondary status that perpetuates gender discrimination. Working at home is not considered labour because this work is largely unseen and no money exchanges hands, but in real terms, by the time a girl leaves home she will have contributed more than Rs 40,000 to the household income. On an average, girls work 10 hours a day in the home and are more likely to drop out of school because of household demands. If girls try to balance school and household chores, they will not perform as well as boys. Girls are kept at home to look after their siblings, allowing their mothers time to earn money outside of the home.

233. India has the lowest female marriage age in the world: three million of the 4.5 million marriages that take place each year, are of girls below the age of 18 years old. In India, although a girl must be 18 years of age before she can be legally married, many child marriages take place nonetheless. Young brides are more likely to be uneducated, dependent and unaware of their rights.

Box 3.4: CARE-India initiative: Girls’ Primary Education (GPE)
In support of Universal Primary Education (UPE), the national goal of the country, CARE-India initiated a GPE pilot project in 1995 for developing innovative and effective strategies for promoting primary education amongst girls. It is aimed at increasing access to education by promoting and supporting formally equivalent education programmes in collaboration with NGOs and community groups. It strives to impact those demand and supply factors which impose impediments in girls accessing education. Project inputs are focused on those issues that are immediate causes of low female literacy.
Some of the major activities of the project include community mobilisation through awareness and training of parents, key persons at the household and village level, school teachers and other stakeholders. Other strategies include generation of demand for girl’s education, increasing the accessibility and linkages with the formal education system and improving both quality and relevance of education. GPE is being implemented in the of Uttar Pradesh and Rajasthan.
The project strategies are based on sound principles of designing inputs at the grassroots as also best practices demonstrated by successful programmes in India and abroad. For the realisation of universalisation the difference between the participation of boys and girls in elementary education is the biggest single gap that needs to be filled. The problem of UPE is in essence the problem of the girl child’s education. Gender disparity, particularly in the rural areas, reflects the social attitude towards the girl child.
The CARE-GPE project has taken due cognisance of this aspect and in a strategic way has addressed the immediate constraints related to low demand.
In the GPE project, it is envisaged that community-based organisations will be the direct implementors of the project. The strategy is likely to ensure and facilitate sustainability.

Source: Umang–Enrichment of Early Childhood Care and Development, CARE-India

234. Early marriage invariably means an early pregnancy because most marriages are consummated when a girl reaches puberty. Early pregnancies endanger the life of both the mother and child, and can cause interruption in the physiological growth or prolonged and obstructed labour. Studies reveal that 540 mothers die for every 10,000 live births in India. Early pregnancy also increases the chances of premature delivery and low-birth weight babies (23 per cent of babies in India are born weighing under 2.5 kg according to an NFHS-2 survey) who are at risk of infant mortality. Moreover, 50 per cent of all women are anaemic.

Promoting education for girls

235. In India, girls are often not sent to school or their education is discontinued at an early age. Gender disparities persist in all educational indicators, especially with regard to enrolment and retention in primary, upper primary and higher levels of school education. The situation is much worse in rural and tribal areas. Eighty-three per cent of the total population of girls in India are enrolled in primary school, but half of the enrolled girls drop out before they are 12 years old. Many parents do not value a girl’s education and prefer to keep girls at home to look after their siblings rather than incur the extra cost of school supplies.

236. The girl child in especially difficult circumstances is thrice disadvantaged on account of poverty, hardship and gender. As per the 1991 census, out of 11.28 million child labourers, 3.42 million girls under 14 years of age were main workers and 1.68 million were marginal workers. In India, much of a young girl’s work is invisible and remains unrecognized and undervalued. A larger number of girls are engaged in the unorganised sector. In rural areas, the majority are unskilled, low paid workers. Nearly 50 per cent of female child labour in urban areas is engaged in household responsibilities and sibling care, or is engaged as domestic child labour. As per Crime in India-1996, the incidence of child rape increased and the share of child rape victims to total rape victims was 27.5 per cent. There has also been an increase in the buying of girls for prostitution (22 per cent), female foeticide (39 per cent) and child marriages (89 per cent). While, juvenile crime in India has declined and during 1995–96 the share of juvenile crime was only 0.6 per cent, there has been an increase in the number of girls apprehended. The proportion of girls apprehended reached 26.3 per cent in 1996. Out of nearly nine lakh prostitutes in India, four lakh are children below the age 14 years. Commercial child prostitution is estimated to be increasing at the rate of 8–10 per cent per annum. Traditional forms of prostitution also exist in India, for example, 50 per cent of all prostitutes in Maharashtra began as ‘devadasis’ (dedication to a local deity in accordance with superstition). Causes of trafficking of girls are poverty, limited economic opportunities, kidnapping, rape, disintegration of rural and tribal communities and forced prostitution. Additionally, destitute and abandoned girls among the street children and young girls in urban slums are commonly victims of exploitation and sexual abuse.

Central government interventions

237. In recognition of the need to address the requirements of girls and women, the Sixth Plan (1980–85) introduced a separate chapter for women. There was an attempt at a holistic planning approach to women, stressing economic independence and advocating a public policy package that included ownership rights and enforcement of wage laws. The Department of Rural Development announced a 30 per cent quota for women in all anti-poverty programmes for the rural areas. A special programme “Development of Women and Children in Rural Areas” was introduced.12 Most significantly, a separate Department for Women and Child Development was created in 1985.

238. The Governmental approach under the National Plan of Action for the Girl Child includes raising consciousness levels of the parents, who are the decision-makers within the family unit. It also aims at eliminating all forms of violence, overt and covert, perpetuated against the girl child and provides inputs for personality development of the girl child, so as to enhance her self-image and enable her to take her own decisions. In 1998, the GOI dedicated the fourth week of September as Girl Child Week. The DWCD led a policy dialogue on “Bridging the Gender Gap” with all interested groups: NGOs, media and Government. Through the week, events were organised in villages, urban slums, schools and colleges. The laws against female foeticide and the Immoral Traffic (Prevention) Act, 1956, are only part of a series of legislation aimed at protecting the rights of the girl child. The Hindu Succession Act was amended in 1993 to ensure equal rights to the girl child in the property of parents. The enforcing of anti-child marriage legislation and raising of the minimum age of marriage in some States, such as Maharashtra, are other measures that protect the rights of girls.

239. Global trafficking of children and women is considered more profitable than the illegal cross-border sale of arms or drugs. A 1991 study by the Central Social Welfare Board found that 30 per cent of prostitutes were below the age of 18 years. Fifteen per cent had become prostitutes before their fifteenth birthday. To tackle this sensitive issue, India hosted an Expert Group Meeting to negotiate the SAARC Regional Convention on Prevention and Combating Trafficking in Women and Children for Prostitution in 1998. The Convention seeks to take measures to prevent cross-border trafficking through proper international Governmental coordination as well as harmonising of various laws and legal provisions relating to trafficking and rehabilitation of rescued victims. Amendments to the Immoral Traffic (Prevention) Act, have been recommended by the Central Advisory Committee on Child Prostitution in 1998. The DWCD is in the process of amending the ITPA so as to place the burden of proof on the trafficker and to enhance punishment. In 1997, in the case of Gaurav Jain vs Union of India, the Supreme Court directed the GOI to constitute a committee to make an in-depth study of the problems of prostitution and children of prostitutes and to evolve suitable schemes for their rescue and rehabilitation. The Committee has drawn up a Plan of Action to combat trafficking and sexual exploitation of children. The progress of implementation of the Plan of Action is monitored by the Central Advisory Committee. In Tamil Nadu, where the fall in the sex ratio has been significant, a cradle scheme has been started. By offering to adopt girls who would otherwise aborted or killed at birth, the State is giving those girls the right to survive and develop. Cradles have been placed at strategic points both within hospitals and outside.

240. The Government of Tamil Nadu has also instituted the Sivagami Ammaiyar Ninavu Girl Child Protection Scheme as a means of bringing changes in the attitude of the population by providing incentives for adopting a positive preference with regard to the girl child. Financial support is given to parents so that they can provide for the education and marriage of the girl child. Only parents who have undergone sterilization after having one or two girl children will be covered under the programme. Almost 83,000 girls have benefited under this scheme so far.13

Box 3.5: Towards empowerment of women
The 73rd and 74th Amendments to the Constitution are landmark steps as they ensure not less than one-third reservation of seats for women among elected membership and functionaries of the local self-government system (Panchayats and Nagar Palikas).
Women have enthusiastically responded to this unique opportunity and today women comprise more than 34 per cent of among the elected local self-government members. They have made an impression not only by their inherent competence, but also their positive responsiveness to basic social issues. There has also been a reduction in corruption wherever women are exercising power. A comprehensive survey undertaken by the Centre of Women’s Development Studies, New Delhi, covering three backward States of Madhya Pradesh, Rajasthan and Uttar Pradesh found: “These new women in panchayats have reported increase in self-confidence, positive change in lifestyle, awareness about critical need of education and increased concern for village development. There are positive changes in their own attitudes and consequent impact on the family. The Amendments have begun a process of legitimacy to women’s new non-traditional role in panchayats which helps the supporting husbands to share responsibilities without the fear of ridicule and makes others, reconsider and think about the women’s new public role.” There are about one million elected women representatives in panchayats. If we take 2.5 candidates per seat about 2.5 million women participated in the election in the first round. Direct participation in the political system by 2.5 million women is itself a major empowering process. Women’s participation as voters has been increasing at a faster rate than men’s.

Source: Gender and Governance in India, S. D. Bandyopadhyay, Economic and Political Weekly, July 29, 2000
Programmes

241. The Department of Women and Child Development is the nodal agency leading the State’s efforts to improve the situation of the girl child. Of these, the Integrated Child Development Scheme, (ICDS), the world’s largest nutrition outreach initiative, is a key intervention. ICDS will cover 90 per cent of the country by the end of the Ninth Plan period and it is supported by a series of targeted interventions. Of these, the Integrated Nutrition and Health Programme is a demand-driven approach operating in seven States, where resources, both material and human are being directed to achieve those changes in health behaviour that can lead to a reduction in mortality and malnutrition. Nutritional needs of adolescent girls are a special area of focus for the Reproductive and Child Health Programme and the proposed National Nutrition Mission. As noted earlier, gender discrimination within the home is often manifest in the unequal access to and the quality of food provided to girls and boys throughout childhood. The effects of years of neglect become visible during adolescence. While one in five adolescent boys is malnourished, 45 per cent of girls are undernourished. The nationwide Adolescent Girls Scheme has been started in 507 ICDS blocks to provide family life education to girls who have dropped out of school. This scheme includes efforts to raise their health and nutritional status and break the intergenerational malnutrition cycle. Girls also learn skills such as tailoring that would help them become economically independent.

242. Since the early 1990s, the Government has recast many of its child-focused projects. The effort has been to ensure streamlining of the delivery mechanism to ensure that girls, particularly from economically and socially disadvantaged families benefit from this process. These efforts have accelerated after the Beijing Conference. Most importantly, the years since Beijing have shown that investments made in the earliest years of a girl’s life ensure greater returns for the child, the family, society and the country.14

243. The Government of India has paid special attention to ensuring that all children, especially girls, SCs and STs have access to primary education. While tuition fees are not charged in State–run schools, most State Governments now provide free uniforms, textbooks and notebooks to girl children. This reduces the financial burden of educating girls. A proposal to provide free education for girls up to university level has also been mooted. Additionally, the problem of girls often having to care for their younger siblings and thus missing school is being addressed. The functioning hours of the ICDS centres are being synchronised with the school hours of the District Primary Education Programme (DPEP) in all blocks where the latter programme is operational. In addition, new ICDS centres are being run either within the school premises or in a room nearby. The availability of child care services has also freed girls to attend school.

244. To supplement the efforts of the Department of Education, DWCD is leading the Girls’ Primary Education project (GPE) in two states with the lowest female literacy—Rajasthan and Uttar Pradesh. Here the effort is to increase girl’s access to education in partnership with local and community groups. This is in line with initiatives launched by States to support the on-going effort to meet the unmet need for education of girls. Studies have shown that it is the perceived economic burden of bringing up a girl, particularly the cost of getting her married, which is at the root of a family’s reluctance to bring a girl into the world. In 1997, as part of the golden jubilee celebrations of India’s Independence, the Prime Minister announced the Balika Samriddhi Yojana, giving cash support to over 2.5 million poor families in which girls were born.

245. There is also a range of initiatives taken by individual States and by some districts and villages. In Rajasthan, under the Shiksha Karmi Scheme for creating para-teachers, young girls who only had secondary schooling, were given special training. Posted to remote rural settlements where often not even a single individual could read or write, these girls have launched quite a revolution. In Madhya Pradesh, the Government operates the Education Guarantee Scheme in collaboration with the local elected leadership. In villages with no school, one school will be provided along with one teacher, if the Panchayat takes on the responsibility of overall school management. In Kerala, educational concessions have been provided to children of socially and educationally backward communities. For instance, girls belonging to the Muslim and Nadar Communities are eligible for special assistance for education.15

246. Supporting the work of gender mainstreaming in all programming is the nationwide effort to develop engendered databases. Sectors for which gender disaggregated data is not available were identified and the Central Statistical Organisation and the DWCD initiated efforts to fill this gap. The Census of 2001 in fact will be the first engendered nationwide, comprehensive information collection exercise. Data gatherers have been specially trained for the purpose and the questionnaires have been analysed from a gender perspective. DWCD has assisted by commissioning pilot surveys to help the process. The Census 2001 will particularly focus on countering the invisibility of women’s work.

247 The Census, the National Sample Survey, the National Health and Family Survey and the Sample Registration System are some of the institutionalised forms used to collect disaggregated data for various groups of children in India.16

C. The Right to Life, Survival and Development
Article 6

248. The GOI’s National Policy for Children, 1974, lays down the framework for actualizing the Constitutional provisions in that “it shall be the policy of the State to provide adequate services to children both before and after birth and through the period of growth to ensure their full physical, mental and social development. The State shall progressively increase the scope of such services so that, within reasonable time, all children in the country enjoy optimum condition for their balanced growth”.

249. The National Health Policy, 1993, gives the highest priority to special programmes for the improvement of maternal and child health. Simultaneously, the National Plan of Action for Children, 1992, also emphasizes the importance of maternal and child health and the targets set in consonance with those of ‘Health for All’. Besides this, the nation’s ongoing maternal and child health programme has been strengthened with the launch of the Reproductive and Child Health Programme in 1997.1 Various measures undertaken by the Government have resulted in a general increase in the life expectancy of people in all regions. (For more details please see section on Basic Health and Health Services.)

Figure 3.1: Expectation of life at birth by sex

G034386903.jpg

250. In India, family-related issues have a direct bearing on the child’s right to life and survival. Emanating from the structure of the family, where the male maintains the continuity of the lineage, there is a preference for sons in most parts of the country and numerous studies of Indian couples have only reiterated this. The NFHS-2 survey shows that 36 per cent of women want sons more than daughters, but only two per cent want daughters more than sons. Son preference is relatively weak in urban areas, among literate women, among women with more education and whose husbands have more education, and among women living in households with a high standard of living. Son preference is observed to be particularly strong in northern and central India and somewhat weaker in the southern and western regions. In tribal populations, the discrimination against women is not severe. The practice of female foeticide, has been recorded in some parts of India. A study on gender differentials in neonatal mortality, using Primary Health Centre (PHC) records shows social causes as the reason for higher female deaths. According to the Indian Penal Code, infanticide is treated as murder and various sections under the Act can be invoked for prevention of the practice. Unfortunately, in most cases, the culpability for the act rests with the mother alone. In a recent ruling of the Madurai Additional Sessions Court, a mother was sentenced to life imprisonment in a case of infanticide, while the father was released.

251. The negative bias against women has taken an alarming dimension recently with the utilisation of the amniocentesis test for detecting the sex of the foetus, followed by selective abortion of the foetus if detected to be female. Apart from the considerable risks to the foetus and the woman, the utilisation of pre-natal diagnostic techniques for selective abortion of female foetuses perpetuates the negative social worth of women. Among the several pre-natal diagnostic techniques like sonography, and chorionic villi biopsy that are being utilised in India, the amniocentesis test has achieved a dubious popularity as the one which provides quick results, and is accurate. These tests can cause a great deal of damage, resulting in bleeding, spontaneous abortions or premature labour. However, the commercial viability of these tests has overtaken ethical considerations. It has been observed that sex detection tests are not confined to big cities but have proliferated to small towns also. The fact that medical technology was being misused was first recognised in 1982 and a campaign was launched to regulate this, culminating in the enactment of the Pre-natal Diagnostic Techniques (Regulation and Prevention of Misuse) Act, 1994. Under this, pre-natal diagnostic techniques and genetic counselling may be conducted in genetic clinics, genetic laboratories and genetic counselling centres registered under the Act. Use of pre-natal diagnostic techniques must comply with the conditions prescribed in the Act, and is permitted solely for detecting foetal abnormalities.

252. The sharp decline in female sex ratios over the years suggests that female infanticide and foeticide might be largely responsible for this phenomenon rather than general neglect of the girl child.2 The sex ratio is a sensitive indicator of the status of women in any society and the decline in the sex ratio in some States is a great cause for concern.3 According to NFHS-2 survey, the lowest sex ratio is in the State of Haryana with 872 females per 1,000 males. Female infanticide has been reported from parts of Rajasthan, Bihar, Uttar Pradesh, West Bengal and Tamil Nadu.4 The Tamil Nadu Government was the first to acknowledge the existence of infanticide in Madurai district of the State in 1992.

253. It has been seen that institutional deliveries increase the chances of survival for a baby born of a typical rural mother. The NFHS-2 shows that one-third of births (34%) in India took place in health facilities, more than half took place in the women’s own homes, and one in eight took place in their parents’ homes. Births taking place in health facilities were about equally divided between those that took place in a private health facility and those that took place in public institutions (such as government-operated district, block, town, or municipal hospitals and PHCs). Only one per cent of births took place in facilities operated by NGOs and trusts. About two thirds of deliveries in urban areas and one-quarter of deliveries in rural areas took place in health facilities. The Sample Registration Survey (SRS) estimated that a slightly lower percentage of births took place in institutions in 1997 (25% of total births in urban areas, and 18% of births in rural areas). Deliveries in health facilities in India rose from 26 per cent at the time of NFHS-1 (1992–93) to 34 per cent at the time of NFHS-2 (1998–99). However, there are large inter-state variations.

Figure 3.2: Sex Ratio

G034386904.jpg

Source: Census 2001.

254. The IMR is a critical measure of a country’s level of human development. Of the 24 million children born in India every year, not all survive to celebrate their first birthday. Conditions for child survival could be assumed to affect girls and boys equally but in fact this is not the case. Girls suffer from special disadvantages, reflected in the fact that female infant mortality rates are higher than male infant mortality rates. The differential is more pronounced in rural areas. Once again, whether a new born baby girl survives or not depends very much on the State in which she is born. In Orissa, nearly 97 out of 1,000 babies born alive die within the first year. In Kerala on the other hand, only 13 out of 1,000 babies do not survive their first year of life.

Box 3.6: Supreme Court orders strict implementation of the PNDT Act
The Supreme Court of India, while hearing the social interest litigation [Writ Petition (Civil) No. 301 of 2000] filed by the Centre for Enquiry into Health and Allied Themes (CEHAT), an NGO based in Mumbai and others vs Union of India, took cognisance of the fact that female infanticide and foeticide still persists, in India in spite of enactment of the Pre-Natal Techniques (Regulation and Prevention of Misuse) Act, 1984 (PNDT Act).
The gist of the order passed by the Court is as follows:
The GOI has been directed to create public awareness against the practice of pre-natal determination of sex and female foeticide through appropriate releases/programmes in the electronic media.
The GOI has been directed to implement with all vigour and zeal the PNDT Act and the rules framed in 1996.
Meeting of the Central Supervisory Board (CSB) to be held at least once in six months.
The CSB shall review and monitor the implementation of the Act.
The CSB shall issue directions to appropriate authorities in all States/Union Territories to furnish quarterly returns to CSB, giving report on the implementation and working of the Act.
The CSB will examine the necessity to amend the Act keeping in mind emerging technologies and difficulties encountered in the implementation of the Act and to make recommendations to the GOI.
The CSB shall lay down a code of conduct to be observed by persons working in bodies specified therein and to ensure its publication so that the public at large can know about it.
All Governments/Union Territory administrations are directed to appoint by notification, fully empowered appropriate authorities at district and sub-district levels and also advisory committees to aid and advise the appropriate authority in discharge of its functions.
All Governments/Union Territory administrations are directed to create public awareness against the practice of pre-natal determination of sex and female foeticide through advertisement in the print and electronic media.
Appropriate authorities are directed to take prompt action against any person or body who issues or causes to be issued any advertisement in violation of the Act.
The CSB and the State Governments/Union Territories have been directed to report to the Court on or before 30th July 2001.

255. Diarrhoea, which is one of the leading causes of child deaths is sought to be combated by the Oral Rehydration Therapy Programme, which was started in 1986–87, and is being implemented for preventing deaths due to dehydration caused by diarrhoeal diseases among children under five years of age. Oral Rehydration Salt (ORS) is being used for the proper management of cases with diarrhoea. The GOI is organising the supply of ORS packets to the States.

256. The large number of deaths in early childhood accounts for the skewed overall sex ratio. Malnutrition is also a significant underlying factor in many of these deaths. The ICDS, based on the rationale that care, psychosocial development and the child’s health and nutritional well-being mutually reinforce each other, provides a package of services that includes supplementary nutrition, nutrition and health education and prophylaxis against nutritional anaemia and vitamin A deficiency.

257. The ICDS, with its opportunity for early childhood development, seeks to reduce both socio-economic and gender inequities. The ICDS programme was launched on October 2, 1975, in 33 blocks more than 25 years ago. Today, ICDS represents one of the world’s largest and most unique programmes for early childhood development. ICDS is the foremost symbol of India’s commitment to her children and it is India’s response to the challenge of breaking the vicious cycle of malnutrition, morbidity, reduced learning capacity and mortality.

258. Recognising that early childhood development constitutes the foundation of human development, ICDS is designed to promote the holistic development of children under the age of six years, through the strengthened capacity of caregivers and communities and improved access to basic services, at the community level. Within this group, priority is accorded to addressing the critical under-three years age group, the period of most rapid growth and development. The programme specifically reaches disadvantaged and low-income segments, for effective disparity reduction. The ICDS provides an integrated approach for converging basic services for improved child care, early stimulation and learning, health and nutrition, water and environmental sanitation. It targets young children, expectant and nursing mothers and women’s/adolescent girls’ groups through nearly 5,00,000 trained community-based anganwadi workers and a large number of helpers, supportive community structures/women’s groups at the anganwadi centre, the health system and in the community.

259. The ICDS offers a powerful community-based outreach system of functions as the convergent interface between disadvantaged communities and Government programmes such as primary health care and education. It contributes to the achievement of major nutrition and health goals embodied in the National Plan of Action for Children, 1992, and the National Plan of Action on Nutrition, 1995. The programme is also the foundation of the national effort for universalization of primary education. It provides increased opportunities for promoting early development, associated with improved cognitive and social skills, enrolment and retention in the early primary stage. By releasing girls from disadvantaged groups from the burden of sibling care, it also enables them to participate in primary education. The ICDS is a major programme channel for addressing the rights of young children, as defined in the UN Convention on the Rights of the Child, to which India acceded in 1992 and it also uniquely addresses the interrelated needs of young children, girls and women (especially during pregnancy and lactation) across the life cycle. Young girls are provided with equal opportunities for early care for survival, growth and development, while adolescent girls, as well as pregnant and nursing mothers receive vital health, nutrition and self-development interventions and crucial child care support. The community education component, targeting women in the reproductive age group also supports community action to improve care for girls and women.

260. Poised for near universal coverage at the turn of the century, ICDS today reaches out to 4.8 million expectant and nursing mothers and 22.9 million children (under six years of age), of disadvantaged groups. Of these, 12.5 million children (three to six years of age) participate in centre-based pre-school education activities. The ICDS network consists of 4,200 projects, covering nearly 75 per cent of the country’s community development blocks and 273 urban slum pockets. While selecting the location for a project, preference is given to those areas which are predominantly inhabited by vulnerable and weaker sections of the society, i.e., SCs, STs and low-income families found in economically backward areas, drought-prone areas and areas in which development of social services requires strengthening.5 The challenge now is to build on the rich experience of the past two-and-half decades and effectively tap the potential of this unique integrated programme, as it moves towards universalisation. Today, ICDS has many meanings for the community—a home-like childcare centre, a play/learning centre, a peripheral health centre, a meeting place for women/mothers, a source of support during calamity and a means to fulfil aspirations for millions of young children. It is proposed to cover the entire country with this scheme by 2002.

261. Adolescence, that is, the age of 12–18 years, has been recognized as a special period in the life-cycle of girls requiring specific attention. There has been concern expressed at the attitude towards menarche and the myths and misconceptions associated with menstruation. The need for sensitively addressing the question of menstrual hygiene, and the physiology and anatomy for developing a healthy understanding of the body and its functions is very important. Recent efforts on sex education with a focus on prevention of infections and pregnancy do not unfortunately address the issue of menstruation. As adolescence is among the most vulnerable periods during the growth and development of a girl, this area is receiving greater research focus in India. The onset of puberty brings with it several social restrictions on the physical mobility of girls and data on education clearly indicates a decline in enrolment rates at this crucial age, especially if the school is not located in the same village or neighbourhood.

Box 3.7: Objectives of ICDS
Lay the foundation for the proper psychological, physical and social development of the chid.
Improve the nutritional and heath status of children below the age of six years.
Reduce the incidence of mortality, morbidity, malnutrition and school dropouts.
Achieve effective coordination of policy and implementation among various departments to promote chid development.
Enhance the capability of the mother to look after the normal heath, nutritional and developmental needs of the chid through proper community education.

Source: Booklet—Integrated Child Development Services (ICDS), Department of Women and Child Development, Ministry of Human Resource Development, GOI.

262. During 1991–92, a special intervention was introduced for adolescent girls, using the ICDS infrastructure. This intervention focuses on school dropouts and girls in the age group of 11–18 years, and seeks to meet their needs of self-development, nutrition, health, education, literacy, recreation and skill formation.

263. This scheme was introduced in 507 selected blocks with the following objectives:

264. The Balika Samriddhi Yojana was launched in 1997 with the specific objective of changing female and community attitude towards the girl child. The scheme also envisages enrolment and retention of girl children in schools.

265. The Apni Beti Apna Dhan (Daughter is My Wealth) scheme introduced by the Government of Haryana on October 2, 1994, aims at improving the social acceptability of girls by making them financially independent. The scheme provides for the following:

(a) The family will receive monetary assistance of Rs 3,000 at the birth of each of the first three daughters;
(b) The mother will be given Rs 500 within 15 days of each girl’s birth. This is meant for the post-delivery needs of the mother;
(c) An investment of Rs 2,500 will be made in the name of each girl child in Government securities within three months of her birth. This investment will be made available to the girl on her eighteenth birthday and she will be free to use the matured amount for either her education, or for setting up an economic venture

266. In December 1995, the Haryana Government expanded the scope of the scheme, and announced a maturity amount of Rs 35,000 and Rs 30,000 as against the earlier Rs 25,000, for girls who agree to defer the encashment of their securities by four years and two years, respectively.7
Registration of deaths

267. The Registration of Births and Deaths Act, 1956, provides for the compulsory registration of all deaths throughout the country. Under the Act, the responsibility for reporting an event occurring in the house lies with the head of the household, and in her/his absence, on persons in the family as specified. For events that occur in hospitals/institutions it is the responsibility of the hospital in-charge (or a person authorized by him/her) to report the events to the local registrar. However, there is a clear lack of incentive in reporting the death of a child and therefore, child deaths do not get reported. The deaths that are registered at the younger ages are reported from medical institutions. In some cities and towns, arrangements have been made for reporting of deaths in the cremation or burial grounds and deaths of even young children do not escape registration. However, the situation is not the same in the rural areas where a large number of dead bodies are not cremated or buried in authorised cremation/burial grounds. In some States, certain officers have been notified to collect death reports from the informants, that is, the household, and report them to the local registrar for registration. This has brought about some improvement in the reporting of child deaths in some parts of the country. However, the registration of deaths of children is still far from satisfactory.8

D. Respect for the Views of the Child

Article 12

268. Freedom of expression is a fundamental right, available to every person in India, including children. The right to freedom of speech and expression has been construed by judicial interpretation in India to include freedom of the press and other media. Although, there is no legislation that specifically mentions the right of the child to express his/her views freely, this aspect will be covered in the proposed National Charter for Children.

269. Out of all the rights of the child under the CRC, this particular right is the least understood and appreciated by adults. The importance of this right lies in seeing the world from the perspective of the child, and in displaying the sensitivity that is so essential when dealing with innocent children. The significance of this right can be best appreciated when one reads what children had to say during the regional consultations—phrases like “violence frightens us”, “we get scared when our fathers are drunk”, are poignant reminders that children have a right to a safe life, and that adults will not be able to give this if they are not willing to listen to children and to understand how their actions are hurting them.

270. The rights of the child under the CRC to have his/her views respected is intrinsically linked to the opportunities available to the child to participate in a wide spectrum of activities, ranging from the home to school life. It is indeed welcome that there is a gradual increase in initiatives to promote child participation in many parts of the country. The initiatives vary in content and comprehensiveness, from participation in activities to expression of views on matters that affect their lives or those of other children or their communities. In some cases, efforts have been made to link hearing children’s views to decision making and implementation processes of programmes for children and local community initiatives. As child participation seemingly gains acceptance in more parts of the country, as demonstrated by a surge in pilot community-based initiatives during the reporting period, there is a need to fully understand the spirit and principles of child participation within the framework of the Convention and the evolving capabilities of children, and to develop a framework for action which will contribute to creating the institutional spaces for promoting meaningful participation and raising the profile of children as actors in their own development and the development of their communities. At the same time, adults will need to change the way they currently perceive children and their potential, so that children can interact in an environment where adults with the authority to make decisions provide them relevant information, actively seek their opinions and value and respect their comments and proposals. This will also lead to the development of their potential and evolving capabilities, thus enhancing their role as citizens and making them actors in the realisation of their own rights.

271. As one examines the implementation of this aspect of the Convention, it is evident that while progress has been made in this area, mainly through the intervention of NGOs, little documented, qualitative information is available about “listening to children views” in judicial proceedings or placement in “alternative care” or in families and school situations. Little is also known of what happens to children’s views and recommendations and there is no feedback to children on what happens within the decision-making forums based on their recommendations.

272. There emerges a need, therefore, to document the progress so far and to review all aspects of children’s participation, in order to evolve a direction for accelerating the implementation of this aspect of the Convention.

273. In recent years, a few voluntary organizations have experimented with innovative approaches where children have been given ample opportunity to express their right to participation in the decision-making process. For instance, Bhima Sangha, which is an association of working children, is a forum to discuss and resolve children’s issues and concerns. Inspired by the model of official unions and prompted by the desire that their grievances should be heard, 10–15 children in Bangalore, with the help of an NGO called Concerned for Working Children, came together in 1989 to form Bhima Sangha. Since its inception, Bhima Sangha has repeatedly raised child labour issues in the public forum, addressed press conferences and held discussions with Government officials regarding steps that could be taken to solve the concerns of working children. In 1997, Bhima Sangha was instrumental in setting up Children’s Council (Makkala Panchayat), which run parallel to the Adult Councils (Gram Panchayats). Children between 6–17 years of age could vote but the candidates were between 12–17 years. Sixty-five per cent of the seats are reserved for girls. Similarly, an NGO named Butterflies has also evolved children’s participation in the decision making process, wherein every fortnight, children at contact points hold a meeting to discuss important issues, critique ongoing activities, plan future activities, etc., under the overall rubric of the Bal Sabha (Children’s Council). Most schools also have students’ councils and parent teacher associations to ensure that the views of children are heard.1

Box 3.8: Creating “children’s government”
Four years ago, UNICEF initiated Children’s Panchayats in association with the Government of Rajasthan to see if children could become agents of change in their own development. Local NGOs conducted a two-day workshop for the adult Sarpanches (elected heads of the Panchayat) and Panchayat members, who then returned to their villages to set up the Children’s Panchayats. Children were asked to attend meetings where the sarpanches explained child rights and the responsibilities that came with the rights, asking the children if they would like to form the children’s government.
The Children’s Panchayat follows the Government provision of one-third reservations of seats for women, with special representation for SCs and the disabled. The children come from different villages and meet once a month. “Right now there is one-third representation for girls in our Panchayat, just like the Government. In our village, boys are considered to be future breadwinners and girls are homemakers. When I think about it, I know this is not fair. I know the seats should be equally distributed between boys and girls, perhaps that is something we can begin to change” explains Mahindra Singh, (15) the elected head of the Children’s Panchayat in Telora Village.
The Children’s Panchayats in Ajmer district have been changing the children’s lives and the life of their community. In one village, children decided that tobacco addiction was a problem. They asked the shopkeepers not to sell tobacco to children who came to buy it for their fathers, because after a while children became curious and tried it themselves. The adult Panchayat supported this decision by levying a fine of Rs 500 to every shopkeeper who sold tobacco to children. The money went to the Children’s Panchayat. Children’s Panchayats have been inspiring villages to plant trees, open libraries and ban the use of plastic bags. Udaan (Flight), a newspaper about children’s Panchayats, is also written, edited, designed and produced by children.
To date, 200 Children’s Panchayats have been created in Rajasthan. UNICEF hoped to create a model that could be implemented by the Government on a Statewise scale. After seeing the success of the Children’s Panchayat, the Director of Adult and Continuing Education, assigned 35,000 adult education centres, which are present in every village, to help create Children’s Panchayat.
What were the constraints? “In the beginning I wondered how this would work, we are very small, how will we work with the adult Panchayat. But then I thought, this might be something I would like to do in future, so I joined in,” explains Chand, a member of children’s Panchayat. There were also initial reservations by the community that children might be creating a parallel system that would then make its own decision, but the Sarpanch of Telora explains“ The children are my eyes and ears, they tell me what is happening in the village and what needs to change.”

Source: UNICEF

274. In Rajasthan, over 100 Children’s Panchayats have been formed by the Bharat Gyan Vigyan Samiti in villages in the districts of Alwar, Baran, Dholpur, Kota, Pali, Jaipur, Karauli and Sikar. These Panchayats draw attention to the problems related to children and prepare children for active participation in the process of development. The Bal Manch (Platform for Children) has been extremely active in voicing the rights of children. Children started the ”Go to School” drive which pushed up enrolment. Bal Manch girls have also become treasurers of small savings groups of adult illiterate women. In some villages, children even try to tackle issues, like preventing child marriage. Though not always successful, this has demonstrated the stand children can take against violations even in the face of adult opposition.

275. In Madhya Pradesh, the Abhivyakti Bal Vikas Sansthan in Dhar district has established 25 Bal Panchayats which have been very active in organising child rights and hygiene campaigns, Meena film shows, training of Bal Panches and sarpanches and conducting school enrolment drives. In Shahjapur district, 80 Bal Panchayats had poster competitions on issues like child marriage, gender discrimination, education, safe drinking water and health. These not only provided creative expression opportunities on sensitive child rights issues but also sensitised the entire village community on child rights issues and the potential contribution of children to the community. In Andhra Pradesh, child participation is taking place throughout the State with the help of NGOs through the Divya Disha school campaign in Hyderabad. The Child Campaigners Club, under the auspices of COVA, a federation of voluntary organisations has also initiated Bal Adalats (Children’s Courts) whose activities centre around issues that concern children.

Box 3.9: Children freely express their views
When Jhangri, a 10-year-old girl from Andhra Pradesh, stood up with courage and said before an assembly of elders that every child must have access to school as all of them want to read and write, she was articulating what Nobel laureate, Prof. Amartya Sen, also says.
She expressed her feelings quite eloquently in words: “Children must get free education and free uniform, books, pencils and other study material. All schools must have teachers who teach and teachers must love children equally. They must not beat them.”
Jhangri was among 14 children who were on the “dias” (podium), representing 14 States of India and sharing their ideas on what every child should and should not have in their childhood. Interestingly, this was not something even adults articulated on behalf of the children except for the group that turns them into causes and gains mileage out of it. Jhangri, Hari and Sangeeta were earlier child labourers. Now they are in school thanks to the intervention of child rights activists. More than 100 such children and an equal number of women community leaders participated in a three-day national workshop on “Children’s Rights In India—Concerns, Responses and Aspirations” which began on October 12, 2000 at Jamia Hamdard, Delhi.

Source: The Hindu, 16.10.2000

276. In Uttar Pradesh, child participation in the State has largely remained an area-specific activity through intensive projects. Children’s participation in their own development is being promoted through Project Masoom in Bahraich district. The project trains adolescent girls as motivators to mobilise other young girls to get involved in their communities and development. Early childhood care, literacy and age of marriage are the focus. Masoom’s interventions are carried out through children’s groups or Bal Sabhas.

277. In Gujarat, School Panchayats exist in many Zilla Panchayat-run primary schools. These structures replicate the structure of the Parliament or a ministry in schools. These are used to encourage children to take decisions about their school and participate in implementing these. In Kargil, Jammu and Kashmir, in 18 Children’s Committees for Village Development have been organised. These focus on capacity development for children and promote their participation in village development. Children organise themselves, identify local problems and initiate necessary actions. Some of the issues they have tackled include teacher absenteeism, school attendance by children and sanitation practices.

278. Children have wholeheartedly and enthusiastically accepted the opportunity to participate in the media. The International Children’s Day of Broadcasting (ICDB), which falls on the second Sunday in December provides children with the opportunity to devote some of the time to the media and voice their views and concerns, becoming broadcasters and producers for a day— producing, reporting, filming and recording stories they want the world to see and hear. During 1996–1997, 10 children were trained for a week at the Indian Institute of Mass Communication and they produced a programme, which was telecast over the national network, Doordarshan, which is the official television wing of the GOI. In December 2000, 31 TV stations and 60 radio stations involved over 2000 children in their programmes for ICDB. The children interviewed leaders, heroes, opinion makers and other adults who have made a difference to society. TV channels such as Doordarshan, STAR and Channel V all featured programmes developed and presented by children, demonstrating a major recognition of children’s right to expression. Mobilising the media began six months ahead of the ICDB, and UNICEF supported four regional workshops during May–October 2000, to work out the strategy for children’s participation the media.

Box 3.10: Fingerprint postcards
One hundred children in a remote village of Uttar Pradesh wanted to know if the water they were drinking was safe, so they wrote postcards to the District Magistrate (DM) asking for water-testing kits.
One postcard after another arrived at the DM’s office, on different days and from different post offices, but all asking for the same thing: water-testing kits. The children signed their names, added a fingerprint for good measure and reminded the DM of the name of their village: Nautala.
The DM bound the postcards together with an elastic band and sent them to the Department of Water. The Junior Engineer visited the village and met the children, who wanted bottle kits to test for bacterial impurities. The Junior Engineer suggested that he would take a water sample to be tested in the district lab but the children were adamant that they had 50 wells and all the water sources needed to be tested. One child added, “We have to see for ourselves if our water is safe to drink.”
The children of Nautala had decided at a meeting of all of the Bal Sabhas or children’s groups, in the village that there was a need to test the quality of their water.

Source: Bachhe—Children in India, 2000, UNICEF

The media gave significant coverage to the ICDB, and several senior journalists wrote about it, pointing the high visibility that ICDB commanded and which established the arrival of children in the field of broadcasting in the country. Sustaining and expanding the initiative and ensuring child participation in broadcasting all year round are the immediate challenges.

SECTION IV

CIVIL RIGHTS AND FREEDOM

(Arts. 7, 8, 13–17 and 37(a))

A. Name and Nationality

Article 7

279. Voluntary civil registration was first introduced in India in the nineteenth century mainly as an aid to public health administration for locating and identifying issues of public health importance and introducing remedial measures to control mortality. Different provinces had different legislations and sometimes, even within the same province, registration was carried out under different laws. The inadequacy of the system and its limited use were prime reasons for its slow evolution in the country. However, in view of the importance of the system in providing continuous and permanent vital statistics for public health administration and demographic analysis, a number of Commissions and Committees studied its inadequacies and made comprehensive recommendations for quantitative and qualitative improvements. These far-reaching recommendations included:

These formed the basis for the enactment of the current law namely, The Registration of Births and Deaths Act, 1969.

280. This Act repealed and replaced all the diverse laws that existed on the subject and thus integrated the system of registration in the country. The Registration of Births Act enables the Government of India (GOI) to regulate registration and compilation, ensuring uniformity and comparability, whilst leaving the States enough scope to develop an efficient system of registration as per their own requirements. While the actual responsibility of implementing the Act lies with the States/Union Territories the Office of the Registrar General has brought out Model Rules in consultation with the Union Law Ministry for adoption by the States, and this has proved to be an effective instrument in unifying and integrating the system nationwide.

281. Making arrangements for the registration of 25 million births on an annual basis is a mammoth task. There are 200,000 reporting units throughout the country and more than 100,000 local registrars. Except in a few States and UTs, multiple agencies are generally involved in registration work at the sub-national level. This poses immense problems of coordination, control and supervision. Therefore, in order to review the progress of registration in a State and also to resolve interdepartmental issues, high-level inter-departmental coordination committees have been constituted in each UT and State.

282. The level of birth registration in India is estimated to be around 54 per cent. Even in States that have achieved high levels of registration, there is considerable lag in the reporting of statistics by local registrars, delaying the compilation of vital statistics at the State and National level. Therefore, the Office of the Registrar General of India undertook a comprehensive review of the functions of the Civil Registration System in India with a view to revamping the various forms currently in use, and reducing paper work and eliminating delays in submission of reports, thereby speeding up the compilation of these statistics.

283. The following information relating to birth is collected during birth registration, according to the format introduced in January 2000.

A copy of the birth report form is in appendix 4A.1.

284. The question on “Town or village of residence of mother” would make it possible to tabulate birth registration data on the basis of the mother’s usual place of residence. While the age of the mother at the time of marriage is a useful demographic data item, the last three items listed above would provide useful information on reproductive and child health issues. In fact, there has been a conscious effort on the part of the Registrar General’s Office to include certain important reproductive and child health items in the birth report form. These items are not collected on a regular or continuous basis through health information systems. This strategy of establishing linkages with other systems enhances the utility and credibility of the Civil Registration System and opens up channels of funding from sources outside the system. The new system has been implemented in the States of Andhra Pradesh, Goa, Jammu and Kashmir, Karnataka, Kerala, Madhya Pradesh, Mizoram, Sikkim and Tamil Nadu and in the UTs of Delhi and Pondicherry. The other States and UTs are in the process of finalising the rules and printing forms, and will soon implement it. The Office of the Registrar General is also developing a common application software package to be used by all the States/UTs for data entry and tabulation of civil registration data.

285. The National Population Policy 2000, recently released by the Department of Family Welfare, Ministry of Health and Family Welfare, GOI, has set 100 per cent registration of births as one of the 14 national socio-demographic goals to be achieved by 2010. The Office of the Registrar General, in July 1999, also issued guidelines facilitating the registration of destitute children taken in adoption from orphanages and other placement agencies as also from relatives and friends.
Birth Registration and the rights of the child

286. All children, whose birth is registered, receive a birth certificate, a legal document that provides proof of date of birth and is required in many situations during the course of life, including:

287. Children who do not have a birth certificate are thus, certainly at a disadvantage. It is important to note that the birth certificate can, for instance, protect a child from exploitation, especially in situations where he or she has to prove his or her age. Proving nationality is not just a hypothetical exercise, it is a practical necessity, whether migrating to the city for work or at a national border or trying to avail basic services.

288. The Office of the Registrar General of India has undertaken several measures to improve the Civil Registration System (CRS). The CRS has been revamped with a view to reducing the paper work and making it more efficient in terms of the flow of returns regarding birth and death registration and making it amenable to the use of modern technology. A national workshop on birth registration was held in May 2000, with delegates from the Office of the Registrar General of India, Chief Registrar of Births and Deaths of several States, representatives of a few international agencies and NGOs.1

289. The following areas were identified for action:

Reducing delay in registration and issue of certificates;

Improving record keeping to facilitate information search;

Proper sign posting of centres;

Improving general format and printing of birth certificates, etc;

Issue of decorative certificates on payment, thereby also generating revenue;

290. Newspaper advertisements, television spots, radio jingles, posters, stickers and cinema slides are some of the measures currently being used to sensitize and mobilize pubic opinion on the need and importance of birth registration. Training and workshops are being organized for registry personnel.3
Citizenship

291. Article 5 of the Constitution of India guarantees the right to citizenship to all its citizens. It holds that every person who is domiciled in the territory of India and:

(a) Who was born in the territory of India; or

(b) Either or both whose parents was/were born in India; or

(c) Who has been ordinarily resident in the territory of India for not less than five years immediately preceding such commencement, shall be a citizen of India.

292. The Indian Citizenship Act, 1955, provides for acquisition, termination, and renunciation of Indian citizenship and other matters. A child born in India or abroad acquires Indian citizenship if either parent is an Indian citizen. A minor child ceases to be an Indian citizen when his parents have renounced Indian citizenship. But any such child may, within one year of his attaining 18 years of age, resume Indian citizenship by making a declaration to that effect.4

B. Preservation of Identity

Article 8

293. In India, the institution of the family plays an important role in preserving the identity of children. Whenever children are separated from their parents, efforts are made to reunite them with their families. Only when such an effort fails are alternative arrangements made, keeping the best interests of the child in mind. The traditional approach primarily has been to set up orphanages for destitute and abandoned children. With the gradual passage of time, however, emphasis is now being laid on alternative care programmes for children deprived of a family environment. When a child is adopted legally, it takes on the name of the adoptive father.

294. The Juvenile Justice (Care and Protection of Children) Act, 2000, deals with children who may be found in situations of delinquency and neglect. The Ministry of Social Justice and Empowerment has been implementing a scheme for the welfare of children in need of care and protection. The objective of the schemes is to take care of and rehabilitate abandoned, neglected, orphaned and homeless children. The welfare services being provided under the scheme include food, shelter, education, health and vocational training.5 Details of the scheme are dealt with under the section on Administration of Juvenile Justice in the report.

295. Article 30 of the Indian Constitution provides a guarantee to all minorities (religious or linguistic) the right to establish and administer educational institutions of their choice. For example, in the State of Delhi, Tamilians have established schools where the children are taught in Tamil till Class IV. Similarly, Sikhs have established schools where they profess, practice and propagate their religion, i.e., Sikhism. Madrasas impart education to Muslim children through the medium of Urdu in several States, including Uttar Pradesh.

C. Freedom of Expression

Article 13

296. Freedom of expression is a fundamental right, available to every person in India, including children. The Right to Freedom of Speech and Expression has been construed by judicial interpretation in India to include freedom of the press and other media. The child’s right to information is sometimes determined by parents or teachers, which may sometimes be misinterpreted as limiting their rights. However, such determination is undertaken predominantly in the best interests of the child and should not be seen as preventing free access to information or freedom of expression. The child’s view is taken into account in a number of cases involving custody, fixing criminal liability and giving evidence in court.

297. The Children’s Film Society, earlier known as the National Centre of Films for Children and Young Persons (NCYP), was formed with the aim of harnessing the medium of films to provide healthy entertainment to children and young people, thereby providing an alternative to commercial cinema. Children also play important roles in films produced by the Children’s Film Society. This gives them a unique chance to give full expression to their creative talents. India also has a censor board which monitors the dissemination of information harmful to children, including violence and pornography on radio and television. Local police and NGOs also play an important role in regulating information and material injurious to children and in monitoring these.6 However, with the growth of information technology, children in India have access to information through the Internet. The fact that this freedom, especially in case of children, may be circumscribed by the cultural ethos of any society needs to be acknowledged.

298. Many newspapers in India publish articles written by children. Some newspapers keep aside a page once a week for children to express their opinion and ideas on various issues. A few leading newspapers have also started collaborations with schools wherein children are given an opportunity to express their views. Most schools in India have school magazines run by children, and children participate in school parliaments and voice their concerns. Doordarshan and All India Radio also broadcast children’s programmes.7

299. The International Children’s Day of Broadcasting (ICDB) is celebrated every year on the second Sunday in December. On this day, children in India have control of allotted time over the electronic media. In December 2000, 31 TV stations and 60 radio stations all over the world involved over 2,000 children in their programmes for ICDB.

D. Freedom of Conscience,Thought and Religion

Article 14

300. Religion is a way of life and for the majority of Indians, permeating every aspect of life, from commonplace daily chores to education and politics. Secular India is home to Hinduism, Islam, Christianity, Buddhism, Jainism, Sikhism and many other religious traditions. Hinduism is the dominant faith, practised by over 80 per cent of the population. Muslims are the second most prominent religious group and are an integral part of Indian society. Common practices have crept into most religious faiths in India and the festivals are marked by music, dance and feasting, which are shared by all, including children. Each religion has its own pilgrimage sites, heroes, legends and even culinary specialities, mingling in a unique diversity that is the very pulse of Indian society. In fact, unity in diversity has proved to be the greatest strength of the country. It is the bedrock on which our multi-ethnic, multilinguistic, multi-religious and multicultural nation proudly stands.

301. Article 25 of the Constitution empowers the citizen of India with freedom of conscience and free profession, practice and propagation of religion, subject to reasonable restrictions. This right applies to children as well. In fact, children’s right to freedom of thought, conscience and religion forms an important part of participation rights.8 At the same time, the right to religion or religious practices is curtailed in instances where there is conflict of religion and the best interests of the society.

302. One such example would be the ban on Sati and the increase in the penalties for the practice of Sati. This has been done to prevent the occurrence of any such incident irrespective of any religious or social sanction. It is therefore recognized that constraints can be placed on practices that may be authorized by religions, in the wider public interest. The Indian Constitution also recognizes the parent’s right to determine a child’s religious beliefs in which it indicates that a guardian can express consent with regard to religious instruction in State schools.9

303. The National Agenda of Governance states that the Government is committed to establishing a civilised, humane and just civil order that does not discriminate on grounds of caste, religion, class, colour, race or sex. It truly and genuinely upholds and practices the concept of secularism consistent with the tradition of sarva panth samadara (equal respect to all faiths) and on the basis of equality for all. The Government is committed to the economic and educational development of the minorities and will take effective steps in this regard.10

304. All minority groups have the right to set up their own educational institutions and give instructions on the teachings of their religion. For example, the institution of Wakf, administered by the Ministry of Social Justice and Empowerment, is dedicated to the purpose recognised by Muslim Law as religious, pious and charitable. Apart from the religious aspect, Wakfs are also instruments of socio-economic upliftment, as benefits provided by them flow to the needy persons for their socio-economic, cultural and educational development. The Maulana Azad Education Foundation has been set up as a society with the objective of promoting education amongst the educationally backward sections of society, minorities in particular, and others in general. Up to January 2000, the Foundation sanctioned grants-in-aid amounting to R 330.6 million, to 24 NGOs spread over 1 States/UTs.11

305. For centuries, India has been known for its religious tolerance. The Ministry of Home Affairs also has a separate division to looks after preservation and promotion of national integration.

E. Freedom of Association and Peaceful Assembly

Article 15

306. Article 19 (b) and 19 (c) of the Constitution of India provide the Right to Assemble Peacefully and to form associations or unions. Freedom of peaceful assembly is permitted for reasonable purposes as laid down by law, subject to reasonable restrictions.12

307. The Nehru Yuvak Kendra Sangathan (NYKS), an autonomous organisation of the Department of Youth Affairs and Sports, caters to the needs of more than eight million non-student rural youth in the age group of 15–35 years enrolled through 0.181 million village-based youth organisations called Youth Clubs. The Youth Club works in the areas of education and training, awareness generation, skill development, self-employment, entrepreneurial development, thrift and cooperation. In addition, programmes are organised with active involvement and participation of rural youth in areas such as health, family welfare, HIV/AIDS, drug abuse, poverty alleviation, child labour, environment, adult literacy, women’s empowerment and eradication of social evils.

308. The Bharat Scouts and Guides is one of India’s largest youth organizations, and the third largest in the world, with an enrolment of 2.3 million and with about 85,000 units spread all over the country. These units conduct activities in the areas of adult literacy, tree plantation, community service, leprosy awareness, crafts and promotion of hygiene and sanitation. Bharat Scouts and Guides are also associated with various programmes run by WHO and UNICEF in different fields.13

309. The Bal Bhavan Society is an association with child members which has over 2,000 regional centres throughout the country providing a host of creative and innovative programmes for children.

310. The Right to Peaceful Assembly has been effectively used by NGOs such as the Social Work and Research Centre (SWRC), Tilonia, Rajasthan, Concerned for Working Children (CWC), Bangalore, Karnataka and Butterflies, Delhi, to name a few. The main objective of their programmes has been to empower children deprived of liberty by helping them form their own associations and unions. The CWC has organized the children into a union called Bhima Sanghas to fight for their rights. It has also assisted children in setting up a Panchayat. Similarly, SWRC has helped to set up a Bal Sansad or Children’s Parliament.14

F. Protection of Privacy

Article 16

311. The concept of family privacy and the role of parents in childcare and nurturing is important in India. Though the State intervenes in child care, parents continue to remain the most important holders of legal authority with respect to the child, with a status higher than that of any third party or public authority. The family thus continues to be recognized as the institution that shoulders the responsibility for child care and development. Courts and public authorities intervene only if the family fails to fulfil its responsibilities towards the child. The legal system in India functions on the principle that it should foster rather than invade family privacy when consulting the child’s wishes and assessing the long-term interests of the child. Judicial review of parental decisions are done in such a manner that a healthy respect for the family is instilled in the child and that the role of the family in relation to the child is not undermined.

312. However, in certain situations, children are exploited, considered as “non-persons” or used as an economic resource. Hence, a right balance between parental rights and responsibilities with regard to nurturing and upbringing of the child, and the child’s right to participation and privacy assumes special significance. The State can intervene to protect children in situations where their rights and interests are in conflict with parental rights and responsibilities. However, in general, State interventions are done in such a manner that they do not conflict with efforts made to strengthen the family.

313. In the area of adoption, owing to strong societal and family ties, the need for secrecy and confidentiality is dominant and the adopted child quite often is unaware of the fact of his/her own adoption. In view of the social stigma attached to unwed motherhood in India, the single mother who gives up her child prefers to do so in perfect anonymity so that none can trace her later. Adoption agencies in India have a sealed and confidential record system whereby there is no access to the relinquishment document and it remains the property of the Court.15

314. The Juvenile Justice (Care and Protection of Children) Act, 2000, prohibits the publication of the identity of any juvenile who has fallen under the purview of the Act, by disclosing the name, address, photograph or other particulars in newspapers, magazines or news-sheets. Section 21 of the Act further prohibits disclosure of name, address or other particulars relating to the juvenile, calculated to lead to the identification of such juveniles or publication of his/her picture in any newspaper, magazine, etc., at the cost of penal consequences. This is aimed at protecting the child against any social stigma attached to any inquiry under this Act. The prohibition is not limited only to inquiries before the competent authority but also applies to any inquiry regarding a juvenile under this Act. It means that the prohibition extends to appeal and revision also. The principle against publicity of juvenile proceedings has been universally accepted. No separate procedures exist to try cases where children are witnesses, and trials of children are conducted under the Juvenile Justice (Care and Protection of Children) Act, 2000.

315. Further, the Immoral Trafficking (Prevention) Act, 1956, lays down that women and girls arrested under this Act will be interrogated by women police officers and if no woman police officer is present, then the interrogation would be carried out in the presence of a lady member of a recognized welfare organization. Additionally, if a child is a victim of rape, then proceedings are held in camera. However, there is scope for improvement in medical and legal aid and counselling provided to children who are victims of sexual abuse and exploitation.

316. The Right of children to counselling is increasingly gaining acceptance. There are numerous Government and private agencies as well as schools offering counselling to children on issues pertaining to health, sexuality, education, career, etc., and there is no restriction on any child to access such a service. Schools in urban cities of India have been successful in providing counselling for their students. Salaam Balak Trust, Voluntary Health Association of India and the Family Planning Association are some organizations that offer counselling to children on HIV/AIDS, reproductive health and personal behaviour issues. Mahila Courts (Women’s Courts), though very small in number, deal with criminal cases pertaining to women and children. These courts are an extension of Session Courts and are meant to give special attention to women and children in protecting them against attacks and interference and in ensuring their privacy. There are family courts with civil jurisdiction to deal with family disputes. There are more than 70 such courts spread all over the country. Generally, lawyers are not permitted in these courts, and the judge can seek advice from psychiatrists and social workers. The privacy of children thus is ensured in the family courts.

G. Access to Appropriate Information

Article 17

317. In a country like India, where the reach of the mass media is limited by poverty, inaccessibility and low literacy levels, other means of communication through word of mouth, community events and performances of mobile, cultural troops play a crucial role in providing information and opinion-building. They create a positive climate in favour of basic education and motivate parents to enrol their children, especially girls, in primary schools and encourage those who drop out to attend non-formal education centres to assist in decision making and resultant action.16 The GOI is therefore developing mechanisms to ensure that all children are allowed adequate access to information. To begin with, community TV sets have been distributed to Panchayats.17 In recent years, the media scene has become increasingly competitive with the coming of private TV channels and radio stations with their own newscasts. One aspect of the proliferation of mass media channels in the urban areas has been the impact of such media on young minds.18

318. The Government reconstituted the erstwhile National Book Development Council (NBDC) in December 1997, and formed the National Book Promotion Council. The Council offers a forum to facilitate exchange of views on issues such as writing, production, publication and sale of books, pricing and copyright, reading habits of people, availability of books for different segments of population and the quality and content of books in general. As per the import policy for books and publications, all kinds of books, magazines and journals, including children’s literature, can be imported without any restriction by any individual or organization. The National Book Trust is an apex organisation which caters to all segments of society by publishing fiction and non-fiction on a variety of subjects in English, Hindi and 11 other Indian languages. It has also published select titles for children in some tribal languages such as Ao, Garo and Khasi. In all, 230 titles in various languages have been published from April to September 1999. The National Centre for Children’s Literature (NCCL) was established in trust to bridge the gap between the creators and readers of literature for the young.19 Journals of the Publications Division (Ministry of Information and Broadcasting) are a good mix of information on issues of national importance and social concerns. Bal Bharti, a children’s monthly journal in Hindi, has been published in a bigger, colourful and more attractive format since January 1999. Further, many private business houses bring out children’s literature like Chandamama, Twinkle, and Amar Chitra Katha (names of children’s magazines).

319. Since April 1999, a new series on sports has also been started. To encourage original writing in Hindi on mass communication, the Publications Division has instituted the Bharatendu Harishchandra Awards. Awards are also given for promoting writing on women’s issues, national legislation and children’s literature.20 The Department of Women’s Studies, NCERT, under the Innovative Pilot Project on Promotion of Primary Education of Disadvantaged Girls in Rural Areas of Haryana prepared posters, campaign songs and audio cassettes, which were disseminated to teachers, children and the community. With the help of the above resource materials, mass awareness campaigns were carried out.21

320. From the very beginning, the Government-owned television channel, Doordarshan, has accorded high priority to programmes on education. The school telecasts started from Delhi in 1961. As part of the Satellite Instructional Television Education, programmes for school- children were started in 1982. At present, school programmes produced by Doordarshan are telecast in regional segments from Delhi and Chennai, and programmes produced by State institutes of education are telecast in Hindi, Marathi, Gujarati, Oriya and Telegu for relay by all transmitters in a particular language zone. Separate slots have been earmarked for programmes for secondary schools on the national network. These programmes are produced by the Central Institute for Educational Technology (CIET). Doordarshan is also providing time on the national network for the telecast of higher education programmes. The Countrywide Classroom of UGC extends higher education to those living in smaller towns and villages. Programmes produced by the Indira Gandhi National Open University (IGNOU) supplement the education provided by other modes such as Distance Education.22

321. The telecast of a programme for children, titled Tarang, was telecast on Doordarshan (DD-I) during the year under report. The current telecast included 473 programme capsules and 92 continuities. A weekly audio programme, Umang, was broadcast throughout the year from 10 All-India Radio Stations, viz., Allahabad, Lucknow, Jaipur, Jodhpur, Bhopal, Indore, Patna, Rohtak, Shimla and Delhi. Eighty-five educational television programmes, covering a wide range of subjects for students and teachers, were scripted and produced. Besides, 29 educational video spots of short duration were conceived, planned and produced. A series of 10 audio programmes, called Rang Ras Barse, was also produced to teach Sargam of different Ragaas (music). Under the series Land and People, two films titled Abode of Gods (with its Hindi version Dev Bhoomi) and Land of Warriors (with its Hindi version Veer Bhoomi) were produced (history and culture).23

322. The Children’s Film Society of India (CFSI) is engaged in the production of films, television serials, featurettes and animation films for children and young people. It endeavours to provide healthy entertainment to the younger generation by exhibiting films and serials in theatres and on television. Rights of foreign films are also purchased by CFSI and the same are exhibited after dubbing them in Indian languages. Films produced by CFSI are entered in various national and international film festivals. The society also organizes its own International Film Festival, which is held every alternate year. Hyderabad is the permanent venue of this biennial event. The eleventh such festival, called the “Golden Elephant”, was held in November 1999.

323. The Festival received 178 entries from 29 countries for its various sections. As many as 49 foreign and 56 Indian delegates were invited. In addition, CFSI invited 50 children as delegates from various parts of India. The Cart a feature film from Iran, bagged the Golden Elephant Award for Best Feature Film. This film also won the Children’s Jury Award. During 1999–2000, nine children’s feature films were taken up for production. These included films in Bengali, Manipuri and Hindi. The CFSI also took up production of two short animation films—Pink Camel and Ajeeb Ghar (Strange House). The society also took up dubbing of one foreign (Persian) feature film Nanelal (Her Children) in Hindi. In the area of exhibition of children’s films, 556 shows were organized in Assam between 20 and 30 May 1999, covering an audience of 190,873. In addition, 1441 film shows were organised by the Mumbai, Chennai and Delhi offices of CFSI, covering the States of Maharashtra, Andhra Pradesh, Karnataka, Kerala, Tamil Nadu, Haryana, Uttar Pradesh and the Union Territory of Delhi.24 Most newspapers in India publish articles for children. Some of the newspapers keep aside a page once in a week for children’s articles, where they can express their opinion and ideas on various issues. With the growth of information technology, a number of websites such as Pitara, Egurucool and Planetvidya provide information specially for children.

324. As regards the development of appropriate guidelines for the protection of their children from information and material injurious to well-being as well as harmful exposure in the mass media, India has a Censor Board which regulates dissemination of harmful information, including violence and pornography on radio and television. Local police also plays an important role in regulating information and material injurious to children.25

325. The Young Persons (Harmful Publications) Act, 1956, lays down provisions to prevent dissemination of certain publications harmful to young persons (under the age of 20 years). According to the Act, harmful publications include books, magazines, pamphlets, leaflets, newspapers or other publications which contain stories told with or without the aid of pictures or wholly of pictures; stories portraying wholly or mainly:

(a) The commission of offences; or

(b) Acts of violence or cruelty; or

(c) Incidents of a repulsive or horrible nature

in such a way that the publication as a whole would tend to corrupt a young person into whose hands it might fall, whether by inciting or encouraging him to commit offences or acts of violence or cruelty or in any other manner whatsoever.26

326. As public service broadcasting organisations, All India Radio and Doordarshan have responsibilities to ensure that advertisements, either in terms of content or treatment, do not mislead the listeners and viewers and are not repugnant to good taste. There are certain restrictions to the right to expression on radio and TV.

327. The General Broadcasting Code, which is otherwise called the Programme Code, for both All India Radio and Doordarshan, prohibits the following:

328. The Cable Television Networks (Regulation) Act, 1995, was enacted to regulate the operation of cable television networks in the country and for matters connected therewith or incidental thereto. Rule-6 (Programme Code) of the Cable Television Networks Rules, 1994, made under the Cable Television Networks (Regulation) Act, 1995, prohibits broadcasting of any programmes that denigrates children. Further, it states that care should be taken to ensure that programmes meant for children do not contain any bad language or explicit scenes of violence. Also that programmes unsuitable for children must not be carried on the cable service at times when viewership of children are the highest. The Advertising Code enacted under the rule prohibits any advertisements which endangers the safety of children or creates in them any interest in unhealthy practices or shows them begging or in an undignified or indecent manner. Such advertisements shall not be carried by cable networks.27

H. The Right not to be Subjected to Torture or Other Cruel, Inhuman
or Degrading Treatment or Punishment

Article 37 (a)

329. Acts of torture and other kinds of cruel, inhuman and degrading treatment to children are penalised under the Indian Penal Code. Measures spelled out in various laws relating to children, including the Indian Penal Code, are taken into cognizance while investigating cases of such atrocities and punishing those responsible. India has a well laid out juvenile justice system which provides for the care, protection, treatment, development and rehabilitation of children who have been physically and psychologically battered so as to reintegrate them back into mainstream of the society.28 Complaint procedures have been spelt out in the Juvenile Justice (Care and Protection of Children) Act, 2000, and remedies thereof are also available for the children. There are also no widespread incidences of victimisation of children in the country. However, whenever such instances come to notice, suitable remedies, as provided in the law, are taken. NGOs such as Bachpan Bachao Andolan (Save Childhood Campaign) and “Concerned for Working Children” (CWC) are spearheading campaigns to prevent torture and other cruel, inhuman and degrading treatment meted out to children. The personnel of child care institutions are being sensitized on the survival, protection, development and participation rights of children.29

Appendix 4 A.1

FORM No. 1 BIRTH REPORT
Legal Information
This part to be added to the birth register as the case may be, in the remarks column in the box below left
To be filled by the informant
  1. Date of birth: (Enter the exact day, month and year the child was born, e.g., 1–1–2000)
  2. Sex: (Enter “male or “female”; do not use abbreviation)
  3. Name of the child, if any: (If not named, leave blank)
  4. Name of the father: (Full name as usually written)
  5. Name of the mother: (Full name as usually written)
  6. Place of birth: (Tick the appropriate entry 1 or 2 below and give the name of the hospital/ institution or the address of the house the birth took place in)
    1. Hospital/Name:
Institution
  1. House Address:
  2. Informant’s name:
Address:
(After completing all columns 1 to 20, informant will put date and signature here:)
Date: Signature or left thumb mark of the
informant
To be filled by the Registrar
Registration No.: Registration Date :
Registration Unit :11
Town/ Village: District :
Remarks: (if any)
Name and signature of the Registrar
BIRTH REPORT
Statistical information
This part to be detached and sent for statistical processing
To be filled by the informant
  1. Town or village of residence of the mother:
(Place where the mother usually lives. This can be different from the place where the delivery occurred.
The house address is not required to be entered.)
  1. Name of town/ village:
  2. Is it a town or village : (Tick the appropriate entry below)
1. Town 2. Village
  1. Name of District:
  1. Name of State:
9. Religion of Family : (Tick the appropriate entry below)
1. Hindu 2. Muslim 3. Christian
4. Any other religion: (write name of the religion)
10. Father’s level of education:
(Enter the completed level of education, e.g., if studied up to class VII but passed only class VI, write class VI)
11. Mother’s level of education:
(Enter the completed level of education, e.g., if studied upto class VII but passed only
class VI, write class VI)
12. Father’s occupation:
(If no occupation write ‘Nil’)
13. Mother’s occupation:
(If no occupation write ‘Nil’)
To be filled by the Registrar
Name Code No.
District :
Tehsil :
Town/ Village :
Registration Unit :
In the case of multiple births, fill in a separate form for each child and write ‘Twin birth’ or ‘Triple birth’, etc.,
To be filled by the informant
14. Age of the mother (in completed years) at the time of marriage: (If married more than once, age at first marriage may be entered)
15. Age of the mother (in completed years) at the time of this birth:
16. Number of children born alive to the mother so far including this child: (Number of children born alive to include also those from earlier marriage(s), if any)
17. Type of attention at delivery: (Tick the appropriate entry below)
1. Institutional – Government
2. Institutional – Private or Non-Government
3. Doctor, nurse or trained midwife
4. Traditional birth attendant
5. Relatives or others
18. Method of Delivery:
1. Natural
2. Cesarean
3. Forceps/Vacuum
19. Birth weight (in kgs.) (if available):
20. Duration of pregnancy (in weeks):
(Columns to be filled are over. Now put signature at left)
Registration No.: Registration Date :
Date of Birth:
Sex: 1. Male 2. Female
Place of Birth: 1. Hospital/ Institution 2. House
Name and Signature of the Registrar

SECTION V
FAMILY ENVIRONMENT AND ALTERNATE CARE
(Arts. 5, 18 (para. 1-2), 9-11, 19-21, 25, 27 (para. 4) and 39)
A. Parental Guidance
Article 5

Family in India

330. The family is perceived as a unit of two or more persons united by the ties of marriage, blood, adoption or consensual unions, generally constituting a single household, and interacting and communicating with each other. It is considered the basic unit of society, to meet the needs of the individuals and those of other societal institutions. It determines the development of individuals, in that it is a major source of nurturance, emotional bonding and socialization. Enriching family life can, therefore, best enhance human development.
331. A family is defined by the Civil Procedure Code, 1908, in order XXXII-A6 as follows:

  1. (ii) Any child or children, being issue of theirs; or of such man or such wife;
  2. (iii) Any child or children being maintained by such man and wife;

Strengths of the family structure

333. The conceptual framework of the Convention with regard to the child, the family and the State is basically compatible with the values of the Constitution, statutes and other laws in India. The legal systems of the region contain principles regulating family relations which do not come into conflict with some basic perceptions on the role of the family and the State in the Convention. The philosophy of the Convention sometimes even incorporates tenets that are more familiar to the indigenous legal traditions of India. These local legal traditions which are more in harmony with the Convention’s value system were modified through centuries of colonial rule, and may need to be restored if some of the concepts on the family that the Convention recognises are adhered to.1
334. Family relations in India are governed traditionally by religious and personal laws. The major religious communities have their separate personal laws. They are governed by their respective religious laws in matters of marriage, divorce, succession, adoption, guardianship and maintenance. The personal laws of minority communities have been left untouched on the basis of the policy of non-interference in the personal laws of any community unless the demand for change comes from within those communities.
335. A strong concept of parental and family responsibility for children emerges from Hindu and Muslim personal laws. A striking common focus on the assumption of responsibility for minor children in the event of death or dissolution of a marriage (according to local laws where divorce has been recognized) emerges in a review of ancient texts. The texts rarely refer to an order of guardians. The karta, or head of the family, was usually responsible for all members of the joint family and on his death another member assumed his role, creating a situation of family relationships that were continuous.
336. Early systems of law in the region also clearly placed the nurturing and care-giving responsibility within the family, thus reflecting a strong concept of family privacy. Hindu law also recognised the important concept of family support or familial assistance, and this was often linked with the right to maintenance from the property of family members. Islamic law recognised a principle that was unique for early legal systems when it conferred a preferential right of custody on the mother of a child of tender years.


Challenges to the family structure

337. The family in India is often understood as an ideal homogeneous unit with strong coping mechanisms. However, it is important to recognize that there may be inherent problems within the family. Moreover, families have plurality of forms that vary with class, ethnicity and individual choices, requiring specific interventions. The concept of family responsibility for children in the earlier systems in the region, while humane in its approach, was combined with a corresponding concept of sweeping family authority. Early legal systems did not recognize the concept of the personal autonomy of the child. Family authority was usually exercised by males, though parts of India such as Kerala and the North-East recognised wide powers in the woman as the head of the household and matrilineal systems of property and inheritance rights. In many cases, the family was and is also the source of inequality, exploitation and violence in addition to its idealistic picture of the source of nurturance, emotional bonding and support.
338. As a social institution, the family has consisted of more or less formal rules and regulations, organized around the fulfilment of societal needs. It has historically been a part of the ethnic community, which has promoted patriarchy in the family, especially in the upper economic groups where property is the base. In a patriarchal structure, age, gender, and generation strictly determine roles and responsibilities and control and distribution of resources. Control over resources and assumption of superiority gives the man the authority to make decisions about his dependants, which would mainly include women and children. With the advent of industrial civilization and with the advancement of technology, new factors of social transformation have begun to accumulate, which are potent enough to create devastating social changes and shatter many of the old foundations of family life. The old role of the family and the scope of economic security it could provide have been eroded. The family is gradually becoming the smallest unit of human association, which is essential for the prime act of procreation. Similarly, large families have become, in most cases, an economic liability instead of an economic asset. The breaking up of the old family system is brought to notice by an increase in child crimes, in the rate of divorces and in cases of desertions.
339. An emerging trend is the formation of some alternative family or household compositions, such as:

Counselling

340. The demands of modern life are such that stress is on the increase. Until recently, the child was the focus while dealing with children with special needs and behavioural problems. Later this shifted to mother-child interaction. The emergence of Family System Therapy led to the realization that family is a dynamic unit and therefore, the focus should be shifted from the child to the relationships of various subsystems, where the child is seen in the context of the family and the family is seen is the context of the community.3
341. Family courts have been established in 19 States/UTs as per the provisions laid down by the Family Court Act, 1984. The Act provides for the establishment of family courts with a view to promoting conciliation in, and securing speedy settlement of disputes relating to, marriage and family affairs and matters connected therewith. Section 6 of the Act empowers the State Government to determine the number and categories of counsellors required to assist a family court in the discharge of its functions.4 All family law matters such as marriage, matrimonial causes, maintenance and alimony, custody, education and support of children and settlement of property come within the jurisdiction of the Family Courts.
342. Family counselling services in India are supported by the scheme of financial assistance to voluntary organisations for setting up family counselling centres. This scheme primarily aims to protect the family and the society at large from breaking up on account of marital discord, dowry disputes, alcoholism, drug abuse or other social problems. The main objective of the scheme is to provide preventive, curative and rehabilitative services to individuals, families and the community. Similarly, parental education programmes and awareness campaigns for parents and children on the rights of the child are being undertaken by NGOs working in the area of child welfare and development.5
343. In many states, the Department of Social Defence has been supporting ‘family counselling centres’.6 Many such services are being offered by voluntary organisations to assist families in dealing with their problems. The Nutrition, Health and Education (NHED) components of ICDS comprise basic health, nutrition and development information related to children and development. Nutrition education is imparted to women through counselling sessions, home visits and demonstrations. Anganwadi workers use fixed days as mother-child protection days, organising small group meetings of mothers, home visits, etc. All efforts are made to reach out to women, including pregnant women and nursing mothers, to promote improved behavioural actions for care of pregnant women, young children and adolescent girls at household and community level. Sustained support and guidance is provided in the period of pregnancy and early childhood, to mothers/families of young children, building upon local knowledge, attitude and practices. This helps to promote early childhood care for survival, growth, development and protection.7

344. The Central Social Welfare Board (CSWB) under the Department of Women and Child Development (DWCD) organizes seminars and awareness camps for women, covering various issues related to the family. Parental education programmes and awareness campaigns for parents and children on the rights of the child are being taken up by NGOs at State and district levels in the area of child welfare and development. Training is provided to concerned professionals of many NGOs on various aspects of child rights, and they in turn generate awareness among people. International agencies like UNICEF and other voluntary bodies have also been making efforts to create awareness about the rights of children among various sections. There are various collaborative efforts, which are doing some excellent work. Voluntary Action Bureau (VAB) and Family Counselling Centres (FCC) under CSWB provide counselling and rehabilitative services to women and children who are victims of family maladjustment and atrocities.8 Leading public schools in India have counselling centres for both parents and children. These centres not only provide career counselling but also provide psychological and emotional guidance.

B. Parental Responsibility
Article 18

345. As noted earlier, families in the region take many forms, since joint as well as polygamous families are recognized in customary and religious laws and social practice. Female-headed families and families formed by cohabitation without marriage are also a reality. In addition to the variety of legal norms in these areas, there are also uniform laws which try to reconcile the standards set by the Convention on this issue.
346. Traditional laws in India, and the South-Asian region as a whole, whether religious or customary, emphasize the aspect of family support. Islamic law recognizes a man’s duty to support his wife and children. The obligation of support in traditional Hindu law has, in fact, been used in India as a basis for the post-Independence codified legislation which now regulates the subject of family support in Hindu law. Thus, both parents have an obligation to maintain a marital or non-marital child. The Criminal Procedure Code, which applies uniformly to all citizens of India, creates a parallel statutory remedy on the subject of family support. This statute is the major law on child support in India, and reflects a different approach to the issue of parental responsibility for financial support.

Policies and legislation

347. According to section 20 of the Hindu Adoptions and Maintenance Act, 1956, a Hindu is bound, during his or her lifetime, to maintain his or her legitimate or illegitimate children. Further, the provision lays down that the legitimate and illegitimate child may claim maintenance from his or her father or mother as long as the child is a minor.
348. Section 24 of the Guardians and Wards Act, 1890, makes the guardian duty-bound to look in to the support, health and education of the ward.
349. Rule 133 of the Islamic law states that every man is bound to maintain his children and grandchildren till the time of weaning. After the time of weaning, in the absence of property, through which they can be maintained, the children and grandchildren shall be maintained:

(a) In the case of sons and grandsons who have not attained puberty and unmarried girls, by the father; and if the father is poor, then by the mother, if she is rich, and if both father and mother are poor, then by the nearest grandparent—paternal or maternal if they are rich. Such maintenance is subject to reimbursement against the person liable to maintain;
(b) In the case of major children, excluding married daughter disabled on account of some disease or physical or mental infirmity, by the father only, but if both the father and mother are rich then by both of them in proportion of 2/3: 1/3;
Box 5.1: Landmark judgement
  • In a recent judgement, the Supreme Court (Githa Hariharan Vs. Bank of India and Vandana Shiva Vs. J. Bandopadhyaya) declared that the mother was as much the child’s natural guardian as the father. Since traditionally much of India has been a patriarchal society where the father is considered the legal guardian, the Supreme Court judgement is a landmark judgement that brings family reality into consonance with the requirements of the CRC.

Source : Response NI/PC/SAP/132/2000/908 dated 31 July, 2000, National Institute for Public Cooperation and Child Development, GOI, page 18

Box 5.2: Udisha
Udisha, the national initiative for quality improvement in training of child care functionaries and care-givers, is fundamental to the improvement in the quality of early childhood care for survival, growth and development.
Udisha recognises parents and communities as the ultimate link in the training chain where behavioural change must take place to promote care, development and active learning of the young child.
It envisages a key transformation in approaches to training of child care functionaries and care-giver education. This is through a holistic approach to the young child, reflected in a new child-centred curriculum that is structured along the life-cycle and development continuum of the child. This pulls together different sectoral interventions, with a rights perspective.
Udisha seeks to address the physical, social, emotional and intellectual development of children, by promoting a convergence of actions in the areas of health, nutrition, early learning and better parenting.
Udisha is seen as an important element in empowering child care workers, parents and communities for a continuous process of assessment, analysis and informed action—to promote the fulfilment of young children’s rights to live, grow and develop.

Source: Booklet—Integrated Child Development Services (ICDS), Department of Women and Child Development, Ministry of Human Resource Development, page 33

Programmes

352. Measures adopted to render appropriate assistance to parents and legal guardians include facilities like day-care centres, crèches, play-houses, early childhood care centres and Anganwadi centres which are run by Governments, State/UTs as well as by NGOs.11 The Central Sector Scheme of running crèches/day care centres was started in 1975 in pursuance of priority objectives of the National Policy for Children adopted in 1974. It aims to provide day-care services mainly for children (0-5 years) casual, migrant, agricultural and construction labourers. Children of women who are sick, incapacitated due to sickness or suffering from communicable diseases are also covered under the scheme, which is framed to cater to the very low economic groups. Services available to children include sleeping and day-care facilities, supplementary nutrition, immunization, medicine, medical check-up and entertainment. The scheme is being implemented by the CSWB through a voluntary social welfare organization, and two other national level voluntary organizations, namely, the Indian Council for Child Welfare (ICCW) and Bharatiya Adim Jati Sevak Sangh (BAJSS) all over the country. The National Crèche Fund (NCF) was set up in March 1994. The general crèches assisted by the NCF follow the pattern of the Department of Women and Child Development’s Crèche Scheme, and provide children below five years services with day care facilities, supplementary nutrition, immunization, medical and health care and recreation. Children of parents who are extremely poor are eligible for enrolment.

Box 5.3: A few interventions by NGOs
Mobile Crèches has been running day-care centres for children of migrant construction workers in Mumbai and its suburbs since 1972. They arrange day-care centres in safe places, where they keep children away from the dangers of the construction site. They provide nutritious mid-day meal, snacks and milk. Doctors come for check-ups and to immunise children. The organisation also arranges for non-formal education with story-telling, play, singing, art and craft, and finally gets children admitted to municipal schools.
Mobile Crèches has been extending services to the construction sites, slum areas and resettlement colonies in Delhi. There are altogether 28 such centres. The core of the programme lies in building positive interactions based on partnership and sharing of perception and knowledge. They carry out daily interaction with parents at the centres on issues pertaining to early childhood care, education and other issues of common concern. They conduct camps (local andoutstation) for community members. This interaction also involves the male members of the child’s family and has proved to be a holistic way to address familial problems, which directly or indirectly affect the child.
Ashraya, located in Bangalore, Karnataka, is committed to finding a solution for children within the framework of their own biological families, or in adoptive homes. Ashraya has crèches at about 30 large construction sites, providing almost 300 children with a safe haven within the building site itself. The trained and committed staff impart literacy and craft training. A nutritious diet, medical cover and immunisation, has improved the health of the children dramatically. Parents’ involvement has grown through family meetings and informal interaction between them and the staff of Ashraya.
In 1996, Ashraya started a residential school for children of migrant labourers, 100 km from Bangalore, near Madanapally, called the Neelbagh Residential School. The school imparts non-formal education to children and has a large component of vocational training as part of the curriculum.
Navjeevan Bala Bhavan is an organisation for street children in Vijayawada, Andhra Pradesh. Under their project called Bala Vikasa Kendra, they provide recreation, basic education, counselling, nutrition and first-aid facilities to more than 150 children in and around Autonagar. At present, more than 75 children attend classes at Bala Vikasa Kendra every day. Out of these, 70 per cent are boys and 30 per cent are girls.
The Spastic Society of Tamil Nadu, in Thiruvallur district has initiated Community Participation Rehabilitation in early intervention and developed a horizontal model with the support of UNICEF, Chennai. This programme is in full partnership with parents of disabled children, with ICDS personnel and with Primary Health Centres. After three years of preparation, one project has been handed over to Parents, Self-Help Group. The focus of this village-based activism, is the empowerment of the disabled people and their families.
Indian Council for Child Welfare, Tamil Nadu, is running 113 crèches in different districts depending on the need. Health care, play-way teaching a nutritious noon meal, leisure activities and celebration of festivals are some of the services provided in these crèches. The mothers are periodically oriented on parenting skills and on better child-rearing practices. The council runs three crèches in industrialised areas like Ambattur Industrial Estate (AIEMA) and Madras Export Promotion Zone (MEPZ). Financial assistance and counselling services are extended to the children and their parents so that the children can pursue their formal education and vocational training.
In Usilampatti, Madurai district Tamil Nadu, apart from extending support to children and parents from the lower socio-economic strata, the focus is on disabled children. The Council was able to reach out to 559 beneficiaries through its counselling and related services.
The Indian Council for Child Welfare, Assam, runs 34 crèches for children of six to seven years of age. These centres are run mostly in rural areas. The family counselling centre run by the Social Welfare Advisory Board in the police headquarters of Ulubari, Assam, has been handed over to the State Council for Child Welfare.

Box 5.4: International conference on early childhood care for survival, growth and development
A new vision for young children in the twenty first century is being evolved — a vision that focuses on promoting early childhood care for survival, development, protection and participation. The vision includes strengthening of family and community capacity to promote care for young children, girls and women. An international conference was organised from 3-5 October 2000 in New Delhi, in order to facilitate India’s new strategy for young children.
It was felt that parents and family members would continue to be the main influence on young children’s lives in the foreseeable future, especially for children under three or four years of age. Perhaps, the greatest and most lasting effect on a child’s learning and development can come from improvement in the capacity of parents to provide a supportive environment for learning and development. The various possible ways to support and work with parents and family members and the particular combination of how to go about this work was discussed at the conference.

Source: Brochure on International Conference on Early Childhood Care for Survival, Growth and Development, UNICEF.

353. The scheme is being implemented through voluntary organizations or Mahila Mandals. The financial norms for the NCF are the same as that for the crèches under the scheme of Assistance to Voluntary Organizations for crèches for Working and Ailing Mothers. The voluntary organisations/Mahila Mandals are required to open the crèches in schools or in places close to schools, in rural and urban slums dominated by SCs/STs. They are encouraged to involve the communities in the implementation of the scheme so that the crèches become self-supporting.12 At present, there are about 14,925 crèches supported by the above scheme benefiting approximately 373,000 children.13 With regard to destitute children , the Government of India (GOI) proffers the Integrated Approach to Juvenile Justice, a scheme under which institutions are set up to look after children who are in need of care and protection. Besides, family assistance is provided through individuals, families and communities. Sponsorship services for poor families are also rendered by various institutions.

C. Separation from Parents
Article 9

354. Separation from parents in the best interest of the child usually takes place when either parent is not in a position to take care of the child because of poverty, ailment, alcoholism or imprisonment; or when parents are not known; or when children are abandoned, or when children become victims of man-made natural disasters.

Neglected juveniles

355. If a neglected juvenile is brought before the juvenile court, the court acts in the interest of the child and directs him/her to be sent to the children’s home in order to provide him/her with proper habitation and care for its physical and moral health.
356. According to the Juvenile Justice (Care and Protection of Children) Act, 2000, during the pendency of any inquiry regarding a juvenile, the juvenile, unless kept with a parent or guardian, would be sent to an observation home or a place of safety for such period as may be specified by the order of the Juvenile Board.14 For more details of the Act, see section on the Administration of Juvenile Justice.


Children of prisoners

357. The Annual Report of the National Commission for Women 1995-96 reports that a number of infants and children accompanied their mothers into the prisons. Facilities for child care, therefore, were also observed and were found to be adequate in only two jails. The National Commission for Women has recommended that infant care facilities like crèches and the ICDS project be established/run in each prison/custodial home for proper care and development of children accompanying women inmates.15


Children in hospitals

358. In India, normally all hospitals allow the parents or the guardian to stay with an ailing child in the hospital.


Custody

359. While the father is always the natural guardian, the mother is given the custody of the child on the basis of what is termed as the “tender age theory”. Custody is granted during pendency of a matrimonial dispute between parents [section 26 of the Hindu Marriage Act (HMA)]. Under the HMA, however, courts have to be guided by the principles of the Hindu Minority and Guardianship Act (HMGA). The mother ordinarily has custody of a child till the age of five years. Under Muslim law, among Sunnis, the custody of the girl child remains with the mother till the age of seven and till the age of two under Shia law (till the child is weaned). In the absence of the father, male relatives get preferential rights for custody.

360. However, courts generally favour the principle of welfare of the child in determining custody, which would depend upon the facts of each case. Even if custody is granted to one parent, the other parent has a right of visitation and cannot be denied access to the child. The orders of custody can also be modified with changed circumstances.16 In the Juvenile Justice Act, 1986, which covers neglected as well as delinquent children, there are suitable provisions to ensure that the child separated from one or both parents has the right to maintain parental relations as well as direct contact with the concerned parents.17

D. Family Reunification
Article 10

361. Migration of a parent or sibling to a foreign country is an important strategy for the economic survival of those left behind at home, particularly among the vulnerable groups of people. Thousands of families in India depend on the remittance of migrant workers as a source of livelihood. In a way, these families have developed their own “safety net” by searching for a job elsewhere, but at a cost. Families that migrate for economic reasons have to deal with social and psychological problems created for the children left behind at home as well as the problem of dealing with tensions in the new place of work. In most cases, only one parent migrates so that the child is left behind with the other parent. The separation of the child from the parent can extend to long periods and would depend upon the economic status of the family.

362. Such Indian migrant families are dealing with increasingly restrictive conditions being placed on the right to family reunification by the host countries. Most countries which account for a major share of Indian migrants abroad, now prescribe detailed procedures for allowing the family to join, leading to delay and uncertainty which have been extremely detrimental to children’s healthy development. There is a long waiting list of children in India seeking to join their parents abroad. Often, delays have ruined children’s chances. In many cases, they pass the age of 18 while still awaiting their visas. A positive, humane and expeditious approach to the issue of granting visa to members of separated families is strongly recommended.

363. Foreigners who desire to visit India, can do so after obtaining a visa from the Indian Mission in the country of their residence, or in the country nearest to them. People of all nationalities can visit India for tourism, business, education or family reunions. Employment visas are also granted if backed by employment contracts. Visas for the spouse and children of foreigners employed in India are automatically granted. A large number of Indians are now seeking job opportunities abroad.

364. According to the Indian Foreigners Act (1946), foreigners may be refused admission at any point of entry if they do not possess valid documents.

365. There appear to be no reported cases where applications to enter or leave the country have resulted in the applicant or the applicant’s family being persecuted or discriminated against. This also applies to asylum-seeking individuals.


E. Illicit Transfer and Non-Return
Article 11

366. This article is primarily concerned with parental abductions or retention outside the jurisdiction of the State Party. Though the article includes non-parents in its scope, it should be noted that Article 35 covers the sale, trafficking and abduction of children. Article 11 applies to children taken for personal rather than “financial” gain, whereas “sale” and trafficking” have a commercial or sexual motive. Those who abduct children for purely personal motives are usually, though not invariably, parents or other relatives.
367. Such instances of illicit transfer and non-return of children abroad, usually by one of the parents, have been rarely reported in India. India, at present, is not a signatory to the Hague Convention on the Civil Aspects of International Abduction (1980).18

Box 5.5: Separated women abandoned by law
It is more than six years since lawmakers were expected to consider an important amendment in the Criminal Procedure Code that would have enhanced the maintenance amount for separated women. The allotted sum was Rs 500 and the proposal was to enhance it to Rs 1,500.
In the current session of Parliament, the Minister of State for Home Affairs, admitted that the Bill was still awaiting the lawmakers’ approval.
The Law Commission had recommended enhancement of maintenance allowance to Rs 5,000 per month. The Government says it will again move a Bill in the Rajya Sabha to implement the Law Commission’s recommendation.
A woman has two distinct rights for maintenance. As a wife, she is entitled to maintenance unless she suffers any of the disabilities indicated in Section 125(4) of the Code; after divorce, she is entitled to claim maintenance from the former husband.
A woman thrown out of her in-law’s house can legally receive an immediate relief of Rs 500 only. The Code which stipulates payment of maintenance has remained unchanged for the last 27 years, though prices have sky rocketed.
Initially, Section 125 of the Code had fixed the maximum maintenance amount at Rs 250. It was amended last in 1973 and the amount was increased to Rs 500. The Act was supposed to provide quick relief to a woman belonging to any religion.
But no amendment has been made in the Code to ensure that she gets urgent interim relief to sustain herself and her children. Due to the tardy litigation process, the immediate relief to the woman in need is ever eluding. In practice, a woman gets the final relief after meeting the heavy expenses of a prolonged multi-tier litigation process.
In its 154th report, the Law Commission recommended that the ceiling of Rs 500 should be waived and a woman who is earning a livelihood also be entitled to maintenance amount. In determining the maintenance amount, the magistrate must take into account not only the food expenditure and education of children, but also money to be set apart for emergencies. It also suggested deletion of the section which deprives a wife from claiming maintenance if “living in adultery.”
Later, the Commission felt that the maintenance amount should be Rs 5,000.

Source: The Times of India News Service

F. Recovery of Maintenance for the Child
Article 27

368. Under most of the personal laws in India, the primary responsibility for the maintenance of a child rests with the father. If the father has no means or insufficient means, then the mother has the obligation to provide for the child. Under all the matrimonial statutes of India, children are treated as part of ancillary proceedings. Under the Hindu Marriage Act, 1955, Special Marriage Act and Indian Divorce Act, proceedings for maintenance are generally filed by the parent with whom the child resides or who has its custody. An interim application is filed by such parent, but it is done during pendency of a proceeding under the Act. Such proceedings could be divorce, judicial separation or restitution of conjugal rights. The court may take note of the wishes of children and pass orders pertaining to maintenance, taking note of its need and education as befitting the status of parties. The order of the court can vary, depending upon the circumstances of the case. The orders can also be passed in a final proceeding where the court decides upon the status of the marriage, but it is always subject to variation as the needs of the child are never static.
369. Under Section 20 of the Hindu Adoption and Maintenance Act, a Hindu is bound to maintain his children (legitimate and illegitimate) as long as they are minors. A daughter is liable to be maintained as long as she is unmarried and unable to maintain herself from her earnings and property. According to section 125 of the Code of Criminal Procedure, 1973 (Cr. P. C), a magistrate of first class may, upon proof of neglect or refusal (as mentioned in the section), order such a person to make a monthly allowance for the maintenance of his wife or child, at a monthly rate not exceeding Rs 500. Ordinarily, maintenance is to be paid till the child attains 18 years, but in the interest of the child, it can continue beyond this age, if the child is studying. Otherwise, it continues in the case of exceptional situations like the ill-health of the child. All orders passed are enforceable like a civil decree, and courts can order attachments of salary. There is no fixed quantum and it would depend upon the income of the parent and the need of the child.
370. Under Islamic law, children are liable to be maintained by their parents. In addition to this, the wife can initiate proceedings under the Muslim Women (Protection of Rights on Divorce) Act, 1986.
371. In cities where the Family Courts Act of 1984 is implemented, matters of maintenance, custody and access come under the jurisdiction of the Family Courts. In such cases the Counsellor submits to the court, a report relating to the home environment of the parents, their personalities and relationship with the child in determining the amount of maintenance to be granted to the child. In case of a neglect juvenile, a competent authority can make an order under the Juvenile Justice (Care and protection of Children) Act, 2000, requiring the parent or other person liable to maintain the juvenile.

372. Section 125 (3) of the Code of Criminal Procedure states that if any person so ordered fails without sufficient cause to comply with an order on maintenance, then the magistrate may, for breach of order issue a warrant for levying the amount and may sentence such a person to imprisonment, for a term which may extend to one month or until payment if sooner made.

Box 5.6: Fostering families—Creating a home away from home
"Bonny baby!”, they called her. “But will she live?” asked her five-year-old brother. He was too shocked to speak when he saw how little his new sister was. When she was brought to the SOS Village in Faridabad, nobody knew whether she’d make it or not. But she did. After ten days of struggle for survival in the incubator, the one-month-old girl sleeps peacefully in her red wool dress, waiting to be given a name. She’s quite unaware of who or where her real mother is or how she was disowned by her real parents. And she’ll never know who they are.
After being born prematurely in the seventh month to an unwed mother in Varanasi, her mother’s relatives made sure she wasn’t brought up there. “An SOS official who wanted her to survive and have a family, brought her here. Now, she is the youngest member of the SOS village (one of 32 in India) here. We’re going to name her soon after a puja ceremony,” says Niharika Chamola, SOS Educational Counsellor.
Be it the earthquake at Latur or the Orissa cyclone that left many children homeless, SOS has changed the definition of an ‘orphanage’ by giving children in its care an SOS family besides basic education. The SOS childrens villages in India try to give a permanent home to the kids with a strong foundation for an independent and secure life,” says Naushad Raza, another Educational Counsellor.
Five-year-old Anubhav loves dancing, while his nine-year-old sister Apoorva wants to become a pilot. Their mother, Kamalini, says, “Anubhav came to me when he was just a few days old, his mother died while giving birth to him, therefore he’s more attracted to me than my other kids. Apoorva is a topper, she’s always absorbed in books. I know she’ll become successful someday. What does Anubhav want to become when he grows up? “Hrithik Roshan,” he says. For Kamalini, these kids are family. “I gave up the choice to have my own kids. It’s been nine years since I began taking care of these kids, it works like any other household, we share our joy and grief together. I help the kids with their homework and take them out for movies and picnics. I also try to save enough money to buy them things, make fixed deposits for a brighter tomorrow.”
But not everyone can become a mother. It’s only after two years of rigorous training that a woman is chosen to play ‘mother’. “The women are observed closely—whether they’re capable of performing the duties of a mother. They go through psychology tests to see if they can handle the traumas some of the children face. If someone can’t be a mother, then they become an aunt to assist the mother,” says Niharika.
But does the past ever haunt these kids? Do they ever wonder if their families are any different from other families? “Sometimes, the past is destructive, especially if the kids come at an older age, they remember the trauma that has touched their lives” says Kusum Sharma, one of the oldest SOS mothers. “I’ve brought up 33 kids. If the child comes to us at a young age, reality introduces itself in a very natural way. It happens when children start going to school—they interact with other kids and come back with questions. If I recall correctly, when one of my daughters, Manjari, was about six, I would often take the kids to play in the park. There she would see other kids come with both their father and mother. One day, she asked me why her dad didn’t come to play with them. Slowly they understand the difference.”
Today, 22 year-old Manjari, who specialises in human resources development, says “For me, this is my family. It’s given me so much. Without them, I would be nothing.”

Source: Times of India.

G. Children Deprived of their Family Environment
Article 20

373. The radical changes in India’s political, socio-cultural and economic environment have had their impact on marginalised children. The immediate causes include:

Box 5.7: Bid to rehabilitate orphans in Orissa
Survival, protection, education and participation would be the four mantras for the Orissa Government while rehabilitating children affected by the cyclone. These have been adopted from the United Nations’ Convention on the Rights of the Child acceded to by India in 1992.
The Government plans to shelter the orphans in day-care centres, short-stay homes and crisis homes-cum-transit homes. The Consortium for Rehabilitation of Children (CRC), a forum comprising the Woman and Child Development Department, Orissa State Council for Child Welfare and 69 NGOs, has so far identified 1,200 orphans and 755 children-at-risk for rehabilitation.
"We have to first ensure the survival and protection of children. After that we can think of their education and participation in the mainstream,” said Commissioner-cum-Secretary in the WCD Department, Tarun Kanti Mishra.
Though many children have been orphaned by the cyclone, not all are assetless. Under the Community-based Rehabilitation (CBR) programme, the Rs 75,000 ex-gratia given to these orphans would be put in a joint account in the name of a special officer from the WCD department and the orphan’s guardian. The monthly interest of Rs 700 would be spent on the child.
The State Government would also form a supervisory committee, comprising an NGO member, a local panchayat official and a Government official, who would periodically if the child is receiving the actual benefits.
The Government has also started a foster mother scheme, called Operation Sneha, under which a foster mother would be appointed for the orphans in the area. For example, in Jhantipari village of Jagatsinghpur district, a widow has been appointed as foster mother to 10 orphans, and has been provided with utensils and other household items. The rehabilitation process would continue for the next six months, after which the programme would be reviewed.
While 18 of the 87 orphanages in the State have shown interest in taking the orphans, many institutions outside the State, like Dayasadan Children’s Trust, run by Saroj Goenka in Chennai, Bharat Sevashram, Help, Sampark, Santi Alias Trust and Salam Balak Trust, have offered to take all the children orphaned in the cyclone.

Source: D.O.No.5-3/2001-SD, Ministry of Social Justice & Empowerment, GOI

375. One of the initiatives in this regard is the Integrated Programme for Street Children, whose objective is to prevent destitution of children and to facilitate their withdrawal from the streets. The programme provides for shelter, nutrition, health care, education, and recreation facilities to street children and seeks to protect them against abuse and exploitation. The target group of this programme are children without homes and family ties, i.e., street children and children specially vulnerable to abuse and exploitation such as children of sex workers and children of pavement dwellers. In addition to voluntary organizations, State Governments, UT administration, local bodies, and educational institutions are also eligible for financial assistance from the Government under this programme.

Box 5.8: Bid to rehabilitate people afftected by earthquake in Gujarat
The Ministry of Social Justice and Empowerment drew up crises intervention model called Sneh Ghars/Mamta Ghars to house children, women and the aged affected by the earthquake in Gujarat. Grants amounting to Rs 274.47 lakhs were released to Indian Council for Child Welfare, Childline India Foundation, Child Relief and You (CRY), Action Aid India Society, Helpage India and Agewell Foundation for setting up of nearly 200 Shelter Homes, Relief Campus, Crises Centres and Mobile Medicare centres in Gujarat. A comprehensive data analysis system has also been prepared to ensure follow up of those affected by the earthquake in Gujarat including children.

Source: D.O.No.5-3/2001-SD, Ministry of Social Justice & Empowerment, GOI

376. Under the Juvenile Justice (Care and Protection of Children) Act, 2000, Section 15 lays down six avenues to be explored so as to ensure that every opportunity is afforded to a child to remain with his/her family. It is only when these six avenues are not successful that the Board will direct that he/she be sent to a special home.
377. The scheme for Prevention and Control of Juvenile Social Maladjustment was revised in 1998-99 with a view to strengthening the implementation of the earlier Juvenile Justice Act 1986 in the country and bringing about a qualitative improvement in the services provided under the scheme to both neglected as well as delinquent children. The salient features of the revised Programme for Juvenile Justice are as follows:

(a) Establishment of a National Advisory Board (NBA) on juvenile justice to advise the Government on matters relating to the implementation of the Juvenile Justice Act 1986 in the country, including the quality of infrastructure and staff available under the Act;
(b) Creation of a Juvenile Justice Fund;
(c) Establishment of a Secretariat for the National Advisory Board;
(d) Appointment of observers to report upon implementation of the Act in different States/Uts;
(e) Institution of a Chair on Juvenile Justice at the Child and the Law Centre of the National Law School of India University, Bangalore;
(f) Training, orientation and sensitisation of judicial, administrative, police and NGO personnel responsible for implementation of the Juvenile Justice Act 1986;
(g) Expansion of non-institutional services such as sponsorship, foster care, probation, etc., as alternates to institutional care;
(h) Provision of scholarship to children being processed under the Act for excelling in academics or in extra-curricular activities.19

378. Guidelines for foster family care as an alternative to institutional care for children awaiting adoption as well as for uniformity in country adoption have been circulated to voluntary social/child welfare agencies and State Governments for implementation. Twenty agencies in India and six agencies abroad have been given recognition/enlistment by the facilitating Ministry for undertaking intercountry adoption during the year 1999-2000.
379. State Governments operate various programmes under Foster Family Care. For instance, in Rajasthan, the Department of Social Welfare (SWD) of the Government of Rajasthan runs Shishu Grahs (children’s homes) independently for children in the age group 0-6 years, left as orphans by unwed mothers or those who are referred by the police, social activists and now through Child Line Services. The Department runs these centres through NGOs, as well by giving them aid. Orphanages are being run for providing parental care to orphans and abandoned or neglected children in the age group of 6-16 years in the case of boys and 6-18 in case of girls. Similarly, about 600 orphanages are functioning in the State of Kerala benefiting about 50,000 children.
380. A lot of care is taken to keep in mind the child's ethnic, religious, cultural and linguistic background while rehabilitating him/her. The option of restoring the child to his/her family is considered the best alternative. Only in the absence of this alternative, are the other options suggested and availed of.

381. Review of the quality of care and treatment provided to the child who has been placed in institutions for care and protection is another responsibility laid on the State. For this purpose, Social Welfare Officers are appointed. They monitor the situation of children placed in homes and foster care. Every social welfare officer is required to submit a monthly report of the children/institutions under his or her jurisdiction to the superior officer. These reports form the basis of any action which needs to be taken. The Juvenile Justice (Care and Protection of Children) Act, 2000, has a provision for involving voluntary organizations in the inspection of children’s homes.

H. Adoption
Article 21

382. It is an accepted fact that full-fledged emotional, physical and intellectual development of a child depends largely on the environment in which it grows up. While the love and affection of biological parents is an ideal impetus for such growth, there is a large number of children who find themselves in orphanages and other such institutions due to various circumstances. Relevant studies have proved that while institutional care may be unavoidable for such children at the initial stage, their best interests lie in being able to find families which will adopt them and provide them with the required emotional and physical security.
383. The very basic definition of adoption is that it is the creation of a parent-child relationship between persons who are not related so by birth. The minimum function of law in creating this artificial parent-child relationship is to put it on par with the natural one. In practical terms, it means that the same mutual rights and obligations that normally exist between parent and a child born to them would automatically apply to the adopted child in relation to the adopted family.
384. In the past, the primary considerations in adoption were the interests of the adopting parents. Interests of the child were not a priority, because these were taken care of within the close-knit family system of the past. Today, the scenario is different. The interests of the child are very much a priority, and the primary motivations of the adopting parents have also undergone changes. Depending upon their personal and social background, they are able to appreciate and accommodate the child’s needs in varying degrees.20
385. Various measures have been taken to regularise and legitimise the adoption process making sure that the interests of the child are regarded as a top priority. Agencies competent to authorise adoption (licensed by the Ministry of Social Justice and Empowerment) are spread all over the country, especially in the major cities. These agencies ensure a smooth administration of the whole process, including appropriate selection according to compatibility, the legalities involved, counselling and supervision following the adoption.

Legislation

386. India is a country of diversities, and various sections of the society have their own personal laws. There is no uniform civil code for people belonging to various religious and cultural groups; hence there are no universally applicable procedures.
387. Legislation related to adoption fall into two broad categories:

392. The Supreme Court of India, while acknowledging that intercountry adoption is at times necessary for those children who would otherwise languish in institutions, in its landmark judgements in the Laxmikant Pandey vs Union of India case directed that preference is to be given for finding homes within India for every orphaned child. The full development of a child’s potential is possible only in the care of a family and as far as possible such a family should be located in the country of the child’s birth. Towards this end, voluntary coordinating agencies have been set up to promote in-country adoption. These agencies maintain a list of prospective Indian parents and match them with children available in various adoption agencies. Any adoption or voluntary coordinating agency can be contacted or approached for obtaining information on correct procedures of adoption. These agencies provide not only factual data, but also psychological and moral support all through the process of adoption.

393. The agencies employ professional social workers whose role is to ensure as smooth and untraumatic a placement of the child with his/her adoptive parents as is possible. These workers know the minutest details of the entire procedure and thus they are indispensable in the process of adoption. Their work profile includes pre-adoptive counselling, selection of the child, legalisation and post-adoptive assistance.

Adoption procedures

394. The first contact of couples seeking to parent the child with the adoption agency is a critical one, as at that point their ideas about adoption may be vague. The social worker of the agency conducting the interview deals with the queries they have in an encouraging manner and gives them the required information in simple and clear language. Once it is apparent that the couple has made a firm decision and are likely to be acceptable as adoptive parents, they may be asked to register with the agency. Upon registration, the couple are given a list of documents they have to obtain. They are also informed of the home study report that will need to be prepared, the financial costs involved and the requirements for follow-up after adoption.
395. Assessing the ability of a prospective adoptive couple to parent a child not born to them is of crucial importance in a successful adoption. The procedure or the main tool for learning about the circumstances about the applicants, which have a bearing on their suitability, is the home study. The home study is prepared on the basis of a series of individual and joint interviews with the applicants, home visits and, if necessary, contacts with the references. The information thus collected covers varied facts related to the adoptive couple, their significant relatives, etc. This ensures that the physical and psychological environment in which the child would go will be conducive to his/her overall development. Once the ‘home study’ procedure is complete and the areas of counselling, if any, have been taken care of, the process of selection of the child for the couple starts.
396. Care is taken that the child resembles them as far as possible in terms of complexion and features as this helps in the process of psychological identification.

Legal procedures

397. In order to secure the child’s interests (and to avoid the specific cases of secret adoption) it is of crucial importance for the agency to ensure that the legal procedures are completed by the couple. This includes:

399. It is essential to ensure that the child is, or will be, legally free for adoption before considering an adoptive couple for him/her. A child relinquished by a biological parent or guardian can be considered free for adoption after proper documents of surrender have been obtained and the stipulated three months reconsideration period has lapsed without the parent or guardian reclaiming the child. In the case of a remanded child, the agency can apply for his placement on a fit person basis after the child is declared destitute by the Juvenile Court/Board. Where the child is court committed, it is necessary to apply to the Director of Social Welfare or the appropriate Government authority of the concerned State for a release order.

400. In the whole process of adoption, the social worker also ascertains the areas, if any, in which the adoptive couple needs support and counselling. It is then the job of this worker to offer the same to the couple in the course of his/her contacts with them. Some areas of counselling which are commonly dealt with are:

Monitoring

402. CARA monitors and regulates the working of adoption agencies which are recognized by the Central Government. It also works in close cooperation with voluntary coordination agencies and enlisted Indian and foreign placement agencies. The main objective of this agency is to facilitate the adoption of as many Indian children as possible. In order to meet the twofold needs of offering support and assistance in the adjustment between the child and the adoptive parents, and observing and assessing the advisability of the placement, supervision is done during preadoptive foster care. On the other hand, post-adoptive supervision and follow-up is mainly and necessarily supportive in nature and should continue until the child is fully integrated into his/her adoptive family. In general, areas like guidance in parenthood, physical and medical care and child development are covered by the social worker during supervision. Fears, anxieties and doubts are dealt with through reassurance and discussion. Besides these, adoptive parents also need assistance in handling the reactions of the relatives, neighbours and friends. If the adoptive parents are helped to deal with their situation of being adoptive parents, they learn to handle the reactions of others.

Table 5.1: In-country and Inter-country adoptions
Year
In-country adoptions
Inter-country adoptions
Total
1995
1424
1236
2660
1996
1623
990
2613
1997
1330
1026
2356
1998
1746
1406
3152
1999
1558
1293
2851
2000*
1870
1364
3234
Total
9551
7315
16866

* This data pertains to only placement agencies recognised for inter-country adoptions

* 11 Agencies are yet to provided last quarter data

Source: D.O.No. 5-3/2001-SD, Ministry of Social Justice & Empowerment, GOI.

Rights of the child

403. According to the law, an adoptive child has the same rights over the property of his adoptive parents as a biological child.
404. The rights of adopted children to find out about their biological parents and the search by a child for his/her roots and identity is a sensitive aspect of the adoption process. There are two points of view regarding what should be done in such a situation. One is that the adopted child has the right to search for his/her roots and identity, and the other is that it is the biological mother’s right to keep her secret and have the confidentiality of her abandonment preserved. Not to be forgotten is the social worker’s code of ethics and her responsibility to keep confidential the records of the biological mother which makes the situation more complex. The adoptive parents also become very anxious during their search because it threatens the security of their parental ties and takes them through the trauma of acknowledging the existence of another set of parents. At present, many agencies promote the view that when the child grows up, information may be given regarding the biological mother’s social background, circumstances and reasons for abandonment. However, the identity of the mother is not revealed, thereby protecting all corners of the adoption triad. Adoption agencies in India have a sealed and confidential record system. There is no access to the relinquishment document and it remains a property of the court.


Inter-country adoption

405. Without doubt, the child integrates best within the country of his/her own origin because of the identification with the cultural milieu closest to his/her roots. Only in the event of no suitable family being available within the country of the child’s origin should the child be rehabilitated through intercountry adoption. Moreover, sincere efforts are made by a few adoption agencies to motivate Indian parents to adopt so that a climate is created in the country for rehabilitation of destitute children. In the absence of statuary laws and government procedures until 6 February 1984, it was within the capacity of any agency to offer a child for adoption to a foreign parent. However, on the said date, the Supreme Court in a landmark judgement of the case, Lakshmi Kant Pandey vs Union Of India (1984) set the principles and norms, and standardised the procedures involved in inter-country adoption. According to the judgement, first preference should be given to Indian families residing in India as far as possible. This judgement was an attempt to make up for the absence of safeguard procedures and effectively tackle allegations of child trafficking and sale of babies. In the Supreme Court judgement, certain normal and procedural safeguards have been introduced to protect the interests of the child which are as follows:

(a) Government adoption authorities in both sender and receiver countries should make inter-country adoption arrangements;
(b) A child study report would have to be prepared by professional workers of an appropriate authority or agency to provide information about the prospective child to be given for adoption, as it would form the basis of the selection of the prospective adoptors of the child;
(c) Similarly, the family study report would have to be prepared by a professional social worker to ascertain the basis on which the applicants were accepted as prospective adopters. It should be ascertained that the adoptive applicants residing abroad, whether of Indian or foreign origin, qualify to adopt a child as per the laws of the country of their residence;
(d) It is essential that in intercountry adoption,
  1. (i) the child is given the same legal status and rights of inheritance, as if she/he has been born to the adoptive parents in marriage; and
  2. (ii) immigration regulations of the concerned country will permit the child to enter the country.

(e) (When the legal adoption process is concluded, the child shall have the equivalent of a birth registration certificate and shall be granted appropriate citizenship.)

406. The above safeguards help in supervising the progress of the child and ensuring that the child is adopted at the earliest in accordance with the law of the country. Directives have also been issued to the adoption agencies to carry out adoption procedure as per rules and regulations laid down by the Supreme Court of India.
407. The Government has set up CARA, which works as the clearing house of information to monitor in-country and intercountry adoptions. The Ministry of Social Justice and Empowerment grants recognition to both Indian and foreign agencies which are engaged in sponsoring Indian children for adoption abroad. seventy-seven agencies in the country have been given recognition for intercountry adoption. In addition, 293 foreign agencies have also been enlisted in more than 25 countries to sponsor intercountry adoption of Indian children.

408. There are no bilateral or multilateral agreements concluded by the State to promote the objectives of article 21 of CRC. However, any person who is residing outside the country and expresses the desire to adopt, would have to follow the guidelines issued by the Supreme Court of India given in Lakshmi Kant Pandey vs Union of India 1984, which has already been mentioned above.

409. Table 5.1 shows the estimated number of children who have found homes through these agencies during the past few years, as per records available with CARA.

410. In India, there are various reported cases of secret adoption. Many people take children away from hospitals/ nursing homes through illegal means and many such cases go unreported. There are also couples who prefer to adopt a male child rather than a female child and it is very difficult to convince them otherwise. At present the process of adoption is understandably very lengthy. As the initial months are very important in a child’s life, it is the intention to place the child in a family as early as possible. However, pre-adoption processes are extremely important even though they give rise to enormous paperwork and a child may have to be kept in the institutions for the first few months of his/her life.

I. Periodic Review of Placement
Article 25

411. An array of welfare services aimed at providing institutional care is available today in India. State governments and various NGOs are currently involved in these institutions, which include:

Children in conflict with the law

413. The Juvenile Justice (Care and Protection of Children) Act 2000 replaces the existing Juvenile Justice Act 1986. This law has a child friendly approach and provides for care, protection, treatment, development and rehabilitation of neglected or delinquent juveniles and for the adjudication of certain matters relating to delinquent juveniles. These children, though a separate category, are also covered by the juvenile justice system. Under the JJA the authorities competent to take action in these cases are the juvenile courts. Section 5 of the JJA, empowers the State Government to constitute Juvenile Courts for any specified area by notification in an official gazette. Every juvenile court consists of a Metropolitan Magistrate or Judicial Magistrate of the First Class. The juvenile court is assisted by two honorary social workers in exercising its powers and discharging its duties.
414. The State Governments can nominate visitors as per Section 54 of JJA, to visit each of the homes established under this Act. The visitor nominated for a home is supposed to visit the homes and make a report to the State Government. For the purpose of supervision, the State Government (section 53 of JJA) may constitute an advisory board to advise it on matters related to the establishment and maintenance of homes, mobilisation of resources, provision of facilities for education, training and rehabilitation of neglected (abandoned) juveniles and delinquent (in conflict with the law) juveniles and coordination among the various official and non-official agencies concerned. The issue has been dealt with in detail under the Article on Administration of Juvenile Justice.


Foster family care

415. The Central Adoption Resource Agency (CARA) under the Government has been set up to monitor the adoption agencies. Further, the Central Voluntary Adoption Resource Agency (CVARA) has been established in every state to monitor the functioning of institutions keeping children under their care. CVARA checks whether all the institutions dealing with children are maintaining the minimum standards of care and providing all the facilities and services required. CVARA inspects the agencies from time to time and gives suggestions if any changes are required. CVARA has to ensure that all children get individual care and attention according to their needs.


Children with disability

416. The Persons and Disabilities (Equal Opportunities Protection of Rights and Full Participation) Act, 1995, is a comprehensive law dealing with definition of various disabilities, prevention, early identification, implementation, mechanisms, education, employment, affirmative action, non-discrimination, care of the severely disabled, recognition of institutions offering services to the disabled, access to built environment, transportation and information. For effective implementation of the specifications laid down in the Act, coordination committees are proposed to be set-up at the Central and State levels. While the majority of the members are proposed to be officials, it has been provided that five persons representing NGOs or associations concerned with disabilities will be members of these committees.22

Box 5.9: Little bride – Amina Begum
The case of Amina, a 10-year-old Indian child bride married with parental consent to an Arab man, was detected by an alert airhostess on a flight out of India. The child seemed to be upset and crying, and the airhostess was able to attract the attention of the authorities so that the man was arrested and prevented from leaving the country. The case attracted a great deal of media attention in India and abroad. The prosecution that has been initiated against the man has also brought non-governmental organizations into the scene.

Source: Children, Law and Justice: A South Asian Perspective, Savitri Goonesekere page 279

J. Abuse and Neglect
Article 19
Including Physical and Psychological Recovery and Social Reintegration
Article 39

417. Child abuse is an extremely complex phenomenon, which has only recently started receiving the attention that it deserves. Child sexual abuse is the physical or mental violation of a child, coupled with sexual intent, usually by an older person who is in some position of trust or powers vis-à-vis the child. Even though men and women can sexually abuse a child, most abusers are male. Because of the more powerful position held by males in society, one generally refers to rape of females rather than of males. Sex abuse in children is not easily accepted in society, but another form of abuse is hardly objected. Corporal punishment is meted in schools in the name of discipline. Other practices include the sale of girls to foreign “buyers”, including much older and affluent bridegrooms.

418. Implementation of laws, in the existing framework, contemplate a parent, person or organisation acting on behalf of the child victim and making a complaint to the court, police, social welfare, probation or child-care authorities. Many NGOs , particularly women’s organisations and concerned activists, have been catalysts in the community response to child abuse. These are all cases in which an individual child obtains access to justice because of the community interest. However, they can have a wider significance when they generate interest and concern with the law reform process. NGOs, have been lobbying for changes in laws to address the problem of child prostitution, and represent the public pressure to initiate new laws and policies.

Box 5.10: Separate legislation on child abuse planned
The Government is contemplating the introduction of a separate legislation on child rape and sexual abuse, which accounts for 27 per cent of the total cases of rape reported in the country. “It is time we think of a separate and specialised legislation for the new methodology of trial and proof for the offence of child rape”, stated the Law Minister, while inaugurating a ‘Sensitisation Workshop on Child Rape and Child Sexual Abuse’ in December 2000. Rape, by itself is one of the most obnoxious crimes but child rape is perhaps the most offensive, requiring special treatment. Unfortunately, the existing rape laws make no distinction between the rape of a minor and that of an adult.
The two-day workshop, jointly organised by the National Human Rights Commission (NHRC) and Angaja Foundation, an NGO working for the rights of the children, was held in December 2000 in New Delhi. The workshop stressed on the need to review the very definition of rape as for the purpose of Section 375 of the Indian Penal Code, the definition of rape applies equally to an adult and a minor.
According to latest figures compiled by the National Crime Records Bureau, the cases of child rape account for 27 per cent of the total cases of rape reported in the country. While Madhya Pradesh tops the list of reported cases of child rape with 806 in 1998, Delhi figures at the fifth place with 239 cases.

Source: The Times of India Online, 15 December, 2000

419. The involvement of the community and concerned individuals is thus crucial for improved law enforcement, the imposition of sanctions on offenders and efforts to strengthen legal controls. It is the absence of this kind of an initiative that often prevents a response from either law enforcement authorities or the legislature to grave exploitation and violence against children in domestic service, child prostitution, pornography, trafficking of child brides or trafficking of children for camel racing to Gulf countries.
420. Child sexual abuse within the family is a deeply disturbing issue, one which the family guards as a secret while others do not want to admit that it even exists.
421. The 1996 survey on child sexual abuse,23 considered a landmark is conducted by Samvada in Bangalore among 348 girl students from 11 schools and colleges, threw up startling data. Conducted scientifically, the study found that:

Legislation

423. The Indian Penal Code has laid down provisions for action against child abuse such as rape, molestation and prostitution. The GOI has adopted appropriate legislative, administrative, social and educational measures to protect children from all forms of physical and mental violence, injury, neglect, maltreatment, exploitation and abuse. The Government has also enacted a number of legislation measures such as:

Corporal punishment

427. Corporal punishment in families is usually not reported, as the family in India is an intensely private institution.
428. The Department of Education has directed the States not to enact such legislation which goes against the International Treaties/Conventions to which India is a signatory, specifically citing the CRC. The National Policy on Education (NPE), 1986, explicitly mentions that any form of corporal punishment should be firmly excluded from the education system. The Department has issued directions to State Governments to consider the issue in all earnest and take appropriate action to prevent corporal punishment and to take action against guilty teachers and schools. The Department of Education is also in the process of:

(a) Launching awareness campaigns to sensitise and dissuade teachers and parents from inflicting such forms of punishment on children;
(b) Examining the possibilities of providing a clause through legislation for imposing a ban on corporal punishment.

429. The GOI, through various circulars issued under the Juvenile Justice Act, 1986, tries to ensure that a child’s rights are protected in juvenile correctional institutions. Also the staff of care institutions is being sensitized to the survival, protection, development and participation rights of the children. A child with the help of the guardian, can report abuse to the police. The victim can also file a complaint to NHRC, NCW and other relevant authorities/Commissions.

Childline Service

430. This service has been initiated by the Government to help children who are suffering from neglect, abuse and exploitation. The Childline Service is a 24-hour free phone service for children in distress which can be accessed by a child in difficulty, or an adult on his/her behalf by dialing 1098. The service which was started in Mumbai is now available in 25 cities, namely, Ahmedabad, Alwar, Baroda, Bhopal, Bhubaneshwar, Kolkata, Chennai, Cochin, Coimbatore, Delhi, Goa, Guwahati, Hyderabad, Indore, Kutch, Jaipur, Lucknow, Mumbai, Nagpur, Patna, Pune, Thiruvananthapuram, Varanasi, Vijayawada, Vishakapatnam. It aims to cover 30 cities by the end of Ninth Five-Year Plan. The basic objective of the Childline Service is to respond to children in emergency situations and refer them to relevant governmental and non-governmental organizations. The service is being standardised to meet common norms and objects. Childline India Foundation has been established as an umbrella organization to identify, provide support services and monitor efficient service delivery of the centres at various locations. It serves as a link between the Ministry and the NGOs in the field. It is now essential to monitor the effectiveness of this facility and assess the quality of follow-up actions and support provided to children through this service.

SECTION VI

BASIC HEALTH AND WELFARE

(Arts. 6, 18, para. 3, 23, 24, 26, 27 paras. 1-3)

A. Health and Health Services
Article 24

Introduction

431. The right of the child to survival and to health has emerged both as an aim and a measure of progress, for children. Child survival is perhaps the most basic fundamental right and yet, like child health, it depends not only on Government programmes and schemes, but on a large number of factors such as the condition of the mother, the care that the young child receives and the ability of the family to access health services either from the Government or private centres.
432. Health is a major concern of the Government, which has an extensive and wide array of initiatives and schemes for ensuring child survival and health. The Ninth Five-Year Plan (19972002) focuses on providing integrated preventive, promotive, curative and rehabilitative services in primary, secondary and tertiary health care institutions, with appropriate referral linkages. It recognises the special health needs of the girl child and the importance of enhancing easy access to primary health care.1 Nonetheless, as the section will indicate, a substantial portion of the health system in India lies outside the Government sector. There are also very wide variations in the success of programmes throughout the country, and a gender bias against the girl child and the woman exists in most places. From an analysis of available data, it is abundantly clear that while the provision of health services for the entire population is the first imperative, the empowerment of women is essential if these services are to be successfully accessed for children.


Overview
Current situation

433. The promotion of child survival and health has been one of the most important objectives of the Government, and steps to strengthen child health services were taken as early as the First Five-Year Plan (1951–1956). A number of programmes, such as the Maternal and Child Health (MCH)/Family Welfare Programmes and the Child Survival and Safe Motherhood (CSSM) programme were implemented from this period onwards. Recognizing that the top-down target approach being followed until then to achieve health goals did not reflect user needs and preferences, the Government took a bold step to make health programmes more client-oriented, with an emphasis on the quality of services and care. This brought about a paradigm shift in the health policies, which is reflected in the Reproductive and Child Health Programme (RCH), launched in 1996. This new programme integrates all family welfare, women and child health services with the explicit objective of providing beneficiaries with “need-based, client-centred, demand-driven, high quality integrated RCH services”. The strategy for the RCH programme shifts the policy emphasis from achieving demographic targets to meeting the health needs of women and children.
434. Infant and child mortality rates reflect a country’s level of socio-economic development and quality of life, and are used for monitoring and evaluating health programmes and policies. It is a matter of some satisfaction that the infant mortality rate (IMR; viz., the probability of dying before the first birthday) has declined from 80 to 70 per 1000 live births over the period 19912000 and 20 of India’s states/UTs have achieved the goal of IMR of 60 by the year 2000 according to the Indian Report on the World Summit for Children. Similarly, the child mortality rate (CMR; viz., the probability of dying between the first and fifth birthday) has declined from 33.4 per 1000 live births in 1991 to 29.3 in 1998. Even neo-natal and post-natal mortality (viz., the probability of dying in the first month of life, and after the first month of life but before the first birthday, respectively) declined by 25 per cent and 33 per cent respectively in urban areas. In fact, IMR/CMR have declined steadily in both rural and urban areas of India. Improved access to health care and to safe drinking water, and the steady expansion of the Integrated Child Development Services (ICDS) have been the primary reasons for these improvements. However, wide regional variations in IMR (13 in Kerala and 97 in Orissa) and maternal mortality rate (MMR) (79 in Tamil Nadu and 707 in Uttar Pradesh) call for State-specific strategies and interventions.

Figure 6.1: Evaluation of health programme and policies

G034386905.jpg

435. The vaccination of children against six serious but preventable diseases—diptheria, pertussis, polio, measles, tetanus and typhoid—has been a cornerstone of the child care system in India. The Universal Immunisation Programme (UIP) was launched in 1985–86 specifically for this purpose. In 1998–99, 42 per cent of children, aged 12–23 months, were fully vaccinated (as against 36 per cent in 1992), 44 per cent received some form of immunisation, while 14 per cent were not reached (as against 30 per cent in 1992). Coverage for individual vaccination is much higher than the percentage of fully vaccinated. BCG, first dose of DPT and first and second doses of polio vaccine have each been received by 71 per cent children. Fifty-five per cent children received three doses of DPT and 63 per cent received three doses of the polio vaccine. Measles vaccine has been received by 51 per cent children.
436. India has achieved considerable success in its campaign to eradicate polio. Launched in 1996, the Pulse Polio Immunisation (PPI) programme has adopted a novel strategy by identifying National Immunisation Days (NID) in December and January every year, and by involving partners from the community in a mass communication initiative. These efforts led to a sharp decline in recorded wild-virus polio cases from 2,276 in 1997 to 265 in 2000. Focused efforts are being made to a address this problem in U.P. and Bihar, which have recorded 35 per cent of the global cases of polio as of end-December 2000.
437. Acute respiratory infections (ARI) are the leading cause of child mortality in India, accounting for about 30 per cent of all the under-five deaths. Under the ARI Control Programme, health workers have been imparted training in ARI management, and co-trimoxazole is distributed through all health outlets. It is estimated that two thirds of children with symptoms of ARI are taken to a health facility. Diarrhoea is the second most important cause of death, accounting for about 20 per cent of all under-five deaths. The Government has launched the Oral Rehydration Therapy (ORT) programme to prevent deaths due to dehydration. In 1998, 62 per cent of mothers knew about oral rehydration salts (ORS) packets, an increase from 43 per cent in 1990.
438. In rural areas, the Government delivers reproductive and other health services through a network of Primary Health Centres (PHC), sub-centres (SC), and other Government facilities. In addition, services can be obtained from private maternity homes, hospitals and private practitioners. In urban areas, health services are available mainly through Government or municipal hospitals, private nursing and maternity homes. The number of PHCs rose from 18,671 in 1990 to 22,975 in 1999; the number of sub-centres increased from 130,336 in 1990 to 137,271 in 1999, and the number of Community Health Centres (CHCs) increased from 1910 to 2935 during the period.
439. The first case of acquired immuno deficiency syndrome (AIDS), caused by the human immuno deficiency virus (HIV), was detected in India in 1986. Since then, HIV prevalence has been reported in all states. Data from sentinel surveillance sites shows that over the years, HIV infection has increased sharply among commercial sex workers. It is rapidly progressing among STD clinic attenders, and is steadily spreading among the low-risk population. The Government of India (GOI) launched a National AIDS Control (NAC) programme in 1987, which focused on increasing awareness of HIV/AIDS, screening of blood for HIV and testing of individuals practising risk behaviour. During the Eighth Five-Year Plan (1992–1997), the National AIDS Control Organisation (NACO) was established under the Ministry of Health and Family Welfare to implement the programme, which consists of five components: strengthening of management capacity for prevention and control of HIV/AIDS; improving public awareness through an information education communication (IEC) programme; improving blood safety and rational use of blood; building surveillance and clinical management capacity; and controlling STDs. Mass media campaigns and interpersonal communications through non-governmental organizations (NGOs) have also been undertaken to raise awareness in the general population about HIV/STD. The National Family Health Survey–II (NFHS-II) data indicates that the Government’s efforts to promote AIDS awareness through the electronic media has achieved some success. However, NHFS–II reveals that 60 per cent of women have not heard of AIDS, and amongst those women who have heard of it, one-third do not know of any way to avoid infection. Awareness of AIDS is particularly low among women who are not regularly exposed to the media, women from Scheduled Tribes, illiterate women, women in households with a low standard of living, and rural women. Consciousness regarding the reproductive rights of women and the impact of HIV, especially among women belonging to marginalized groups are emerging challenges requiring attention from policy planners.
440. The Government is committed to providing safe drinking water and sanitation facilities to every village to achieve the goal of “Health for All”. The Ninth Plan strategies seek to attain universal coverage of drinking water through different programmes. The increase in access to safe water has been substantial in the last few years. The Multi-Indicator Cluster Survey (MICS) 2000, indicates that almost all households (99.1 per cent) have access to a source of drinking water within 1,600 metres. Safe drinking water is available to 83 per cent households, and 42 per cent households have a source of drinking water within their premises. Incidentally, lack of sanitation contributes significantly to diseases. Access to proper sanitation increased in this decade and more than one third of households (36.5 per cent) use toilet facilities (MICS2000). Among the users, 72 per cent have the facility within their premises. The Government plans to adopt a demand-driven low-cost sanitation approach in preference to a supply-driven approach. A network of production centres and sanitary marts would be integral components of the new self-sustainable sanitation programmes.
441. The proportion of underweight children decreased from 52 per cent in 1992–93 to 47 per cent in 1998–99 (NFHS-II). Similarly, the percentage of babies born with low birth weight (LBW) fell from 30 per cent in 1992-93 to 22 per cent in 1998-99 (NFHS-II). However, the three indices of nutritional status—weight for age, height for age and weight for height—still indicate a high prevalence of malnutrition among children under three years of age. Almost half the children under three years of age (47 per cent) are underweight, and a similar proportion (46 per cent) are stunted or short for their age. The proportion of children who are severely undernourished is 18 per cent in the case of weight for age and 23 per cent in the case of height for age. About 16 per cent children are wasted or too thin for their height. The rate of malnutrition is decreasing at only 0.8 per cent per year. Malnutrition is much higher in rural than urban areas and in children from disadvantaged groups. The urban data presented are not disaggregated to indicate malnutrition level in the urban poor. Micro-nutrient deficiencies in the population persist, despite the fact that there has been a gradual reduction in the prevalence of goitre. Bitot’s spot and anaemia among women.2
442. The current position and the position in 1990 regarding major indicators on health are given in table 6.1.
Thus,

Table 6.1: Major indicators on health
Indicator
1990
2000
Infant mortality rate
80
70
Under-five mortality rate
109.3
94.9
Maternal mortality rate
437
540
Underweight Prevalence
Proportion of under-fives who fall below minus 2 and below minus 3 standard deviations from median weight for age of NCHS/WHO reference population
53.4%/20.6%
47.0%/18.0%
Use of safe drinking water
68.2%
77.9%
Use of sanitary means of excreta disposal
30%
36%
Antenatal care
62.3%
65.1%
Childbirth care
34.2%
41.7%
Birth weight below 2.5 kg.
30.0%
22.7%
Children receiving vitamin A supplements
Not available
27%
Exclusive breastfeeding rate
51.0%
55.2%
Polio cases
10,408
255
Neonatal tetanus cases
9,357
4,488
Measles cases
89,612
38,950
DPT immunisation coverage
51.7%
46.4%
Measles immunisation coverage
42.2%
50.2%
Tuberculosis immunisation coverage
62.2%
67.5%
Children protected against neonatal tetanus
60.9%
60.2%

Source: India Report on Follow-up to the World Summit for Children, 2000, Department of
Women and Child Development, Ministry of Human Resource Development, GOI


The health system

443. Health services for children are provided through a network of sub-centres (SCs), Public Health Centres (PHCs) and Community Health Centres (CHCs). In addition, facilities for children are provided through Post-partum Centres, District Hospitals and Rural and Urban Family Welfare Centres3. Details of rural primary health care infrastructure and manpower available are given in table 6.2. In addition to this, there are more than 15,000 hospitals and almost 30,000 dispensaries throughout the country.4


Other health sectors

444 Around one million individuals are engaged in the private practice of various systems of medicines, throughout the villages of India, as well as in almost every urban bazaar and marketplace. Private health practitioners come from a wide range of backgrounds, most with no

Table 6.2: Rural primary health care infrastructure and manpower
Category of centre
Requirement for 1991
Functioning as on 30.6.99
Gap/(Surplus)
Sub-centre (SC)
134,108
137,271
(3163)
PHCs
22,349
22,975
(626)
CHCs
5587
2935
2652
ANMs at SC
134,108
134,086
22
Doctors at PHCs
22,349
25,506
(3158)
Specialist at CHCs
22,348
3741
18,724

Source: Annual Plan, 2000-01, Planning Commission, GOI.

formal training, having learned as apprentices or keen observers of other older healers. Some have been trained in traditional Indian systems of medicine, but a majority of them (not to be confused with trained allopathic medical practitioners) use modern allopathic medicines as they are perceived to provide quick relief. These practitioners earn their living largely by selling the medicine they prescribe to their clients, adding a small mark-up to the price they have paid to drugsellers in the nearby towns and cities. Conveniently located in most villages or small towns, they are culturally accepted. As a self-financing and ubiquitous part of the health care system of India today, they need to be brought more fully into the system, through training and regular contact to improve the quality of care they provide, and to assure that they recognize conditions requiring referral and treatment beyond their own capacity. The lack of recognition and acceptance of the private health practitioners by the public health system is a major challenge to the health care system in India, for shaping the health of its people in the years ahead.5
445. The modernization of the traditional system began with the establishment of medical training colleges for these systems. This led to the emergence of three Medical Councils, one each for modern medicine, for the Indian system of medicine (ISM) (Ayurveda, Unani and Siddha), and for Homoeopathy. It is estimated that up to three fifths of doctors registered in India, belong to the traditional systems of medicine. Although practitioners of traditional systems also practice modern medicine, the Supreme Court of India has ruled that such cross-medical practice is in violation of Medical Council laws and that it amounts to medical negligence. Village level micro-studies show that the majority of the rural population use the facilities available under the non-modern system of health care. These are not captured in the household level health surveys conducted at the national and district levels.
446. As per census data of 1991, allopathic doctors predominantly serve urban areas and doctors from the other systems are largely prevalent in the rural areas. Roughly, there is one urban doctor for 387 urban persons, which is comparable to developed countries. However, there is one doctor for 1611 persons in rural areas.


Indian systems of medicine and Homoeopathy

447. The term Indian systems of medicine covers the systems which originated in India as well as those which originated outside, but were adopted by India in course of time. These systems are Ayurveda, Siddha, Unani, Yoga and naturopathy. Homoeopathy originated in Germany and is holistic in its approach. The Indian systems of medicine, although prevalent in the country since the earliest times, is becoming increasingly popular in recent times. The stress and tensions of modern life are encouraging people to look for cures other than that provided under the allopathic system. Some success stories of theses alternative systems are frequently heard of.6


Regional variations

448. The indicators given in table 6.1 are the national averages. However, it is important to bear in mind that there are tremendous variations in the pace of progress and the actual status of development in India’s states and Union Territories (UTs). In so far as social indicators are concerned, it has been established that some States and UTs perform very well on all indicators, while the performance of many chronically backward States needs improvement. However, a few States, viz., Bihar, Madhya Pradesh, Rajasthan, Uttar Pradesh and Orissa, have contributed to depressing the national averages. Table 6.3 gives an indication of some of the variations in India pertaining to population, Total Fertility Rate, Birth Rate, and date at which replacement level is likely to be reached.

Table 6.3: Variations pertaining to population, total fertility rate, birth rate,
and date at which likely to reach replacement level
State/Uts
Population@ (millions)
Per cent of total population
Total fertility rate#
Birth rate$
Date at which likely to reach replacement level (TFR=2.1)
Andhra Pradesh
75,728
7.5
2.5
21.7
2002
Arunachal Pradesh
1091
0.01
2.8
22.3
*
Assam
26,638
2.6
3.2
27.0
2015
Bihar
82,879
9.9
4.4
30.4
2039
Chhatisgarh
20,796
*
*
*
*
Goa
1344
0.15
1.5
14.3
*
Gujarat
50,597
4.8
3.0
25.4
2014
Haryana
21,083
1.9
3.4
26.8
2025
Himachal Pradesh
6077
0.67
2.5
23.8
*
Jammu & Kashmir
10,070
0.99
*
*
*
Jharkhand
26,909
*
*
*
*
Karnataka
52,734
5.2
2.5
22.3
2009
Kerala
31,839
3.2
1.8
18.0
Achieved in 1988
Madhya Pradesh
60,385
7.9
4.0
30.7
Beyond 2060
Maharashtra
96,752
9.1
2.7
21.1
2008
Manipur
2389
0.25
2.4
18.6
*
Meghalaya
2306
0.24
4.0
28.7
*
Mizoram
891
0.09
NA
17.0
*
Nagaland
1989
0.16
1.5
*
*
Orissa
36,707
3.5
3.0
24.1
2010
Punjab
24,289
2.3
2.8
21.5
2019
Rajasthan
56,473
5.3
4.2
31.1
2048
Tamil Nadu
62,111
6.1
2.0
19.3
Achieved in 1993
Tripura
3191
0.37
2.1
17.0
*
Uttar Pradesh
166,053
17.0
4.9
32.1
Beyond 2100
Uttaranchal
8480
*
*
*
*
West Bengal
80,221
7.9
2.6
20.7
2009
Andaman & Nicobar Islands
356
0.03
1.9
18.1
*
Chandigarh
901
0.08
2.1
17.9
*
Dadra & Nagar Haveli
220
0.01
3.5
32.4
*
Daman & Diu
158
0.01
2.5
26.9
*
Delhi
13,783
13.9
1.6
19.4
*
Lakshadweep
61
0.007
2.8
25.1
*
Pondicherry
974
0.11
1.8
17.7
*
Sikkim
540
0.05
2.5
21.6
*
India
1,027,015
——
3.3
26.1
2026

Source: @ Provisional Population Totals, Census 2001

$ 1999-SRSBulletin, Volume 34 No 2, October, 2000

# Registrar General of India

** For smaller states/UTs, TFRs are for the period 1995-97.

Table 6.4: Variations in Infant Mortality Rate, Maternal Mortality Rate,
life expectancy at birth, sex ratio and death rate
State/UTs
IMR$
MMR$
Life expectancy at birth
Sex ratio$$
Death rate$
Andhra Pradesh
66
159
61.55
978
8.2
Arunachal Pradesh
43
*
*
901
6.0
Assam
76
409
57.34
932
9.7
Bihar
66
452
63.55
921
9.1
Chhatisgarh
*
*
*
990
*
Goa
21
*
*
960
7.2
Gujarat
63
28
61.53
921
7.9
Haryana
68
103
63.87
861
7.7
Himachal Pradesh
62
*
*
970
7.3
Jammu & Kashmir
*
*
*
900
*
Jharkhand
*
*
*
941
*
Karnataka
58
195
61.73
964
7.7
Kerala
14
198
70.69
1058
6.4
Madhya Pradesh
91
498
56.83
920
10.6
Maharashtra
48
135
65.31
922
7.5
Manipur
25
*
*
978
5.4
Meghalaya
56
*
*
975
9.1
Mizoram
19
*
*
938
5.5
Nagaland
*
*
*
909
*
Orissa
97
367
58.52
972
10.6
Punjab
53
199
68.39
874
7.4
Rajasthan
81
670
60.32
922
8.4
Sikkim
49
*
*
875
5.8
Tamil Nadu
52
79
65.21
986
8.0
Tripura
42
*
*
950
5.7
Uttar Pradesh
84
707
61.20
898
10.5
Uttaranchal
*
*
*
964
*
West Bengal
52
266
64.50
934
7.1
Andaman & Nicobar Islands
25
*
*
846
5.5
Chandigarh
28
*
*
773
3.9
Dadra & Nagar Haveli
56
*
*
811
5.9
Daman & Diu
35
*
*
709
7.1
Delhi
31
*
*
821
4.8
Lakshadweep
32
*
*
947
4.7
Pondicherry
22
*
*
1001
6.9
India
70
407
62.30
(Pooled) 62.36
933
8.7

*Data Not Available

Source: $ 1999-SRS Bulletin, Volume 34 No 2, October, 2000

$$ Provisional Population Totals, Census 2001

Figure 6.2: Sex ratio 2001

G034386906.jpg

Quality of services

452. The mere availability of health centres does not always lead to better utilization, as is evident from a Planning Commission evaluation study on the functioning of CHCs. The most important finding of the study is that utilization of health centres is influenced by the ability to deliver the complete package of services. Poor maintenance and consequent deterioration of buildings and equipment, staff vacancies, as well as poor supply and logistics have been major factors responsible for sub-optimal functioning of the existing health care institutions. According to the Ninth Plan approach paper, this sub-optimal functioning is responsible for the non-availability of health services rather than lack of availability of health centres. Inappropriate location, poor access, lack of maintenance, lack of professional and para-professional staff at critical posts, lack of funds for essential drugs, etc., have been mentioned as reasons for the poor functioning of primary health care institutions.
453. NFHS-II survey has revealed that most households in India (65 per cent) go to private hospitals/clinics or doctors for treatment when a family member is ill. Only 29 per cent normally use the public medical sector. Even among poor households, only 34 per cent normally use the public medical sector when members become ill. Most respondents are generally satisfied with the health care they receive. Ratings on quality of services are, however, lower for public sector facilities both in rural and urban areas than for private sector/NGO/trust facilities. Reliance on the private medical sector is higher in urban areas than in rural areas. Private sector facilities are also perceived to be cleaner than public sector facilities. Seventy-five per cent of women who visited a private sector facility said that it was very clean compared with 52 per cent of women who visited a public sector facility.
454. A disturbing finding that persists in most paediatric units of hospitals throughout the country, is the excess number of boys in comparison to girls seeking medical care. Many parents seek modern health care for their boys earlier than for their girls, resulting in a decreased survival rate of the girl child. This cause of ill health is clearly social and must be addressed.
455. Privatization is increasingly being seen as a solution for improving the quality of health services, particularly at the village level. The Prime Minister has called upon private companies in India, both local and foreign, to adopt health facilities. It is under consideration that companies adopting health centres, would be exempted from income-tax and corporate-tax levies.


The major health interventions

456. The initiatives started by the Government through successive Five-Year Plans and ongoing programmes like the MCH and CSSM, were integrated in 1997, into a holistic approach embodied in the Reproductive and Child Health (RCH) programme, which aims at:

Integrated Child Development Services (ICDS)

458. The ICDS, started in 1975, seeks to empower communities for the care and development of their children and women. Today, ICDS represents one of the world’s largest and most unique programmes for early childhood development—an initiative unparalleled in history. ICDS is the foremost symbol of India’s commitment to her children—India’s response to the challenge of breaking the vicious cycle of malnutrition, morbidity, reduced learning capacity and mortality.
459. The programme provides an integrated approach for converging basic services for improved child care, early stimulation and learning, health and nutrition, water and sanitation—targeting young children, expectant and nursing mothers and women and adolescent girl groups. They are reached through nearly 500,000 trained community based anganwadi workers (AWWs) and an equal number of helpers, supportive community structures/women’s groups through anganwadi centres (AWCs), the health system and in the community.


460. ICDS today reaches out to 4.8 million expectant and nursing mothers and 30 million children (under six years of age) of disadvantaged groups. Of these, 12.5 million children (three to six years of age) participate in centre-based pre-school education activities. In all, there are 4344 projects, covering nearly 75 per cent of the country’s community development blocks and 273 projects covering urban poor pockets8. The supplementary food provided under the scheme has 300 calories and 8–10 grams of protein for children, 600 calories and 20 grams of protein for severely malnourished children, and 500 calories and 20–25 grams protein for expectant and nursing mothers. The National Prophylaxis Programme, for prevention of blindness caused by vitamin A deficiency and control of nutritional anaemia among mothers and children, are two direct interventions integrated in ICDS. Dietary promotion is an important part of nutritional health education, and targeted supplementation is provided

Box 6.1: The potential for improving child survival in India
Kerala has achieved remarkable success in lowering its fertility and IMR. As against a national crude birth rate of 26.1 in 1999 and an IMR of 70, Kerala reported a crude birth rate of 18 and IMR of 14. Tamil Nadu and Goa, too, have been able to bring about impressive reductions in fertility rates and infant mortality in recent times. These examples show the potential that exists within the country to reduce fertility and child mortality. The implications of such improvements are significant. Should all of India reach Kerala’s fertility and infant mortality levels, then there would be 10.2 million fewer births every year, and 1.8 million fewer infant deaths. This would not only reduce dramatically the stress on the health care system, but would also greatly relieve families, and mothers in particular, of the enormous physical and emotional stress that accompanies child bearing and child death.
Kerala has been the focus of development studies for years, trying to understand how a State in the lower quartile of per capita income could achieve such low levels of fertility and IMR. The answer lies in a multiplicity of features—the importance of any individual one is hard to measure. Surely, female literacy and the extremely high rate of school attendance are critical. Added to this is the decentralised nature of the health services, with a health facility within walking distance of almost every home. A politically active community has traditionally demanded good service from Government functionaries at all levels, be it in schools, health centres, or Government offices—this is in considerable contrast to other parts of the country. Population density and the ease of communication may also contribute to the delivery and availability of social services. While some cite religious and cultural precedents—such as the high proportion of Christians (25 per cent) and missionary activities in the past and the matrilineal practices of the Nair community, which gave women a far higher value in the family than elsewhere, the incorporation of the Malabar coast, with its predominant Muslim communities into Kerala only 40 years ago raises some questions. In a few decades, this highly uneducated and relatively less healthy community has come up to the norms of Kerala, achieving good health, low fertility, high levels of education and extensive participation of women, even in the most predominantly Muslim district of the country, in Mallappuram. Surely a combination of education, improvements in the reach, efficiency and utilisation of health services, and a politically conscious and active community can transform Indian society in a relatively short period.

Source: Rights and Opportunities, The Situation of Children and Women in India, UNICEF, India, 1998

461. Recently, the concept of community-based nutrition surveillance has been introduced through ICDS. A community growth chart for monitoring nutritional status is maintained at each anganwadi—the focal point for providing services to beneficiaries. The community growth chart surveillance exercise mobilises community support in promoting and enabling better child care practices by contributing local resources and in improving service delivery and utilisation. A special intervention for adolescent girls was introduced in ICDS during 1991–92 to meet needs of self-development, nutrition and health education, literacy, recreation and skill formation. The scheme implemented in 507 ICDS blocks, and attempts to improve the malnutrition and health status of girls in the 11–18 years age groups. There is persistent demand from States on the urgent need to provide ICDS cover to adolescent girls in all its projects. In 2000-2001 a nation wide unique intervention aimed at empowerment of adolescent girls has been launched in 2000 blocks, called the Kishori Shakti Yojana; the scheme is expected to benefit 12.8 lakh adolescent girls.


Mortality
Neo-natal mortality

462. The major causes of neo-natal mortality are sepsis (bacterial infections), birth asphyxia and prematurity. These are responsible for almost half of all neo-natal deaths. New-born deaths in the first week of life are predominantly caused by birth asphyxia and prematurity, whereas those after the first week are mostly due to sepsis. Other factors which contribute to adverse neo-natal outcome include lack of care of the mother during pregnancy and childbirth, young age and poor general health of the mother.


Infant Mortality Rate (IMR)

463. In 1999, the IMR for India was 70 per live births. Orissa has the highest IMR at 97 and Kerala, the lowest at 14 (see Figure 6.4) Twenty States and UTs have achieved the national goal of IMR of 60 by the year 2000 (see Box 6.2).

Box 6.2: States/UTs and the national goal (IMR)
States/UTs which have achieved the national goal of 60
Major States: Karnataka, Kerala, Maharashtra, Punjab, Tamil Nadu, West Bengal.
Smaller States/UTs: Arunachal Pradesh, Goa, Manipur, Mizoram, Meghalaya, Sikkim, Tripura, Andaman & Nicobar Islands, Chandigarh, Dadra and Nagar Haveli, Daman & Diu, Delhi, Lakshadweep, Pondicherry.
States/Union Territories between 60 (national goal) and 70 (national IMR)
Major States: Andhra Pradesh, Gujarat, Haryana, Bihar.
Smaller States/UTs: Himachal Pradesh
States/UTs above the national average
Major States: Assam, Madhya Pradesh, Orissa, Rajasthan, Uttar Pradesh.

Source: Office of Registrar General of India, Sample Registration Systems, 1999

464. As with all other indicators, there are wide variations among States. Kerala, with an IMR
of 14, compares with some of the more developed countries in the world, while very few countries in the world have IMR higher than Orissa. A positive feature of IMR figures for the last four years is that Bihar and Rajasthan have both shown a decline—in Bihar it has reduced from 71 to 66 and in Rajasthan, from 85 to 81. In Uttar Pradesh also, the IMR has declined from 85 to 84 during this period. With a national average of 70, 30 out of every 1000 children born in India die before their first birthday while there are around 18 million births annually. Therefore, with an IMR of 70, more than half a million babies in India, every year, do not survive beyond the age of one year. It has been suggested that India’s preoccupation with the eradication of polio has led to less attention being given of other components of the Universal Immunisation Programme (UIP). The slow rate of decline in the IMR and the fact of its having plateaued for the last four to five years are issues that are being addressed with a sense of urgency.


Child mortality

465. This is defined as the probability of dying between the first and fifth birthdays. As per data provided by NFHS-II, child mortality has fallen from 39.3 per cent in 1988 to 29.3 per cent in 1998. However, the child mortality rate in rural areas is almost twice of that in urban areas.


Maternal Mortality Rate (MMR)

466. This is defined as the number of maternal deaths of women aged between 15–49 years per 100,000 live births. The Registrar General of India has estimated that the MMR in India is 407 per 100,000 live births in 1999. According to NFHS-I and NFHS-II, the MMR in 1992 and 1998 was 437 and 540, respectively. This increase is not statistically significant. Almost all the estimates imply that more than 100,000 women die each year due to causes related to pregnancy and childbirth. High MMR is mainly due to the large number of deliveries being conducted at home and by untrained persons, severe anaemia, poor nutritional status, ante-and post-partum

Figure 6.3: Infant Mortality Rate 1996-1999

G034386907.jpg

Source: Sample Registration System Bulletin, October 2000, Registrar General, India
*This information was collated prior to the creation of the states of Chhatisgarh, Jharkhand and Uttaranchal

haemorrhage, toxaemia, abortion and sepsis. . In addition, lack of adequate referral facilities to provide emergency obstetric care for complicated cases also contributes to high maternal mortality and morbidity. It is estimated that at least 15 per cent of all pregnant women require skilled obstetric care, in the absence of which they suffer from serious morbidity and disabilities. The complications that affect expectant mothers affect the foetus also. Uttar Pradesh has the highest MMR at 707 (as of 1998) and Gujarat, the lowest at 28 (as of 1998). The MMR for India and its bigger States is given in Figure 6.5.
467. Maternal mortality is also affected by a whole range of socio-economic determinants. The status of women, the relatively low level of female education, economic dependence, lack of access to services and the gender bias are some factors that influence maternal mortality and morbidity. Hospital-based data reveal that States like Kerala, Karnataka, Tamil Nadu, Maharashtra, Andhra Pradesh, Punjab and Haryana, which have relatively better socio-economic conditions and literacy rates, have a lower MMR than the other States. Thus, besides improving maternal health care services, it is necessary to improve the social status of women, including their educational standard, to reduce the current MMR.468. Infant and maternal mortality also remains high, partly because of the occurrence of high risk births, i.e. birth by very young mothers, births that take place too soon after a previous birth, and “high order” births. Children of very young mothers have an IMR that is almost one and half times higher than that for mothers in their 20s. Similarly, the IMR for births that occur within 24 months of a previous birth is almost three times as high as for children born after an interval of four years or more—yet one birth out of every four occurs within 24 months of a previous birth. Although the ideal family size is less than three children, 28 per cent of births are of the order four or higher. Children at higher birth orders also have a higher risk of dying in infancy, and this risk increases the higher the birth order. Encouraging women to

Figure 6.4: Maternal Mortality Rate, 1998


G034386908.jpg

have only the pregnancies they choose and to use spacing methods of contraception can help to reduce high-risk births.

469. Continuing low levels of education among women and under-utilization of safe motherhood services, i.e. antenatal care and safe delivery systems by women are also keeping infant and maternal mortality high. The IMR for illiterate mothers is more than two and half times the rate of mothers who have completed high school. Similarly, infant mortality for children of mothers who did not receive ante-natal care (ANC) from a health worker, delivery assistance from a health professional, and post-partum care within two months of delivery, is also more than twice as high as for mothers who received all these types of care.
470. All the findings relating to MMR reinforce the urgency of ensuring that all pregnant women receive adequate ANC during pregnancy and adequate diet and that deliveries take place under hygienic conditions with the assistance of trained medical practitioners. Under the Maternal Health Care Programme, several interventions have been identified and vertical schemes have been formulated, such as the National Nutritional Anaemia Control Programme, TT Immunisation of Pregnant Mothers and the Dais (traditional birth attendants) Training Programme.9 Due emphasis is being given to provision of antenatal care (ANC) to all pregnant women. Interventions include early registration of pregnancy, insisting on at least three ante-natal check-ups, provision of prophylaxis against tetanus and iron folic deficiency and referral services.10 Essential obstetric care provides for basic maternity services to all pregnant women through:

Table 6.5: Maternal mortality rate, 1998
States
MMR
Andhra Pradesh
159
Assam
409
Bihar
452
Gujarat
28
Haryana
103
Karnataka
195
Kerala
198
Madhya Pradesh
498
Maharashtra
135
Orissa
367
Punjab
199
Rajasthan
670
Tamil Nadu
79
Uttar Pradesh
707
West Bengal
266
India
407

Note: The data for smaller States and UT have not been presented here in view of their small sample size, These figures, however, have been taken into account for working out the figures for India

Source: Sample Registration System Bulletin, April 2000, Registrar General, GOI

Low Birth Weight (LBW)

474. Low birth-weight babies face substantially higher risks of dying than do babies of normal birth weight. According to NFHS-II, 23 per cent of children born weigh less than 2.5 kg. The proportion of children weighing less than 2.5 kg is slightly higher in rural areas (24 per cent) than in urban areas (21 per cent). Low birth-weight occurs due to several reasons. These include poor nutritional status of the mother, hypertension, anaemia, malaria, other infections and tobacco abuse by the mother. Low maternal literacy, early pregnancy, frequent pregnancies, and poor care during pregnancy add greatly to the risk of LBW babies.
475. Interventions that are being undertaken by the Department of Welfare in the Ministry of Health and Family Welfare (MOHFW) include promotion of appropriate timing of first pregnancy (not before 20 years of age), spacing of birth, provision of ANC, provision of iron and folic acid (IFA) during pregnancy and lactation, and institutional delivery.14


Immunization

476. The vaccination of children against six serious but preventable diseases (tuberculosis, diphtheria, pertussis, tetanus, poliomylitis and measles) has been a cornerstone of the child health care system in India.

477. According to NFHS-II, 42 per cent of children aged 12–23 months are fully vaccinated and 14 per cent have not received any vaccination. Coverage for BCG, DPT, and polio (except polio 0) vaccinations is much higher than the percentage fully vaccinated. BCG, the first dose of DPT, and the first and second doses of polio vaccine have each been received by at least 71 per cent of children. Fifty-five per cent of children have received three doses of DPT and 63 per cent have received three doses of polio vaccine. Although DPT and polio vaccinations are given at the same time as part of the routine immunization programme, the coverage rates are higher for polio than for DPT (especially for the first two doses), undoubtedly because of the Pulse Polio campaigns. Not all children who begin with the DPT and polio vaccination series go on to complete them. The difference between the percentages of children receiving the first and third doses is 16 percentage points for DPT and 21 percentage points for polio. Fifty-one per cent of children aged 12–23 months have been vaccinated against measles.

Box 6.3: Schemes to improve the outreach of services
To cater to the RCH needs of people living in far-flung, difficult-to-reach areas, the MoHFW is operationalising several outreach schemes. Notable amongst these is the Border Districts Cluster Project in which selected backward districts are being provided resources to innovate with the purpose of reducing the IMR and MMR by at least 50 per cent in the next three to four years.
The RCH Outreach Scheme is being implemented to improve the delivery of MCH services in remote areas and urban slums. Selected districts will be provided additional support for mobility of staff, improvement in quality of services and generation of demand for services. In the current year, the scheme has been operationalised in 50 districts. The scheme will be expanded to cover 150 additional districts in 2001–02.
To improve the utilisation of services at the PHC level, a scheme for organising RCH camps has been introduced in 102 districts of 17 States. These districts have adverse RCH indicators. During the camps, services of specialists (gynaecologist and paediatrician) will also be made available to the beneficiaries.
Since a large number of deliveries still take place at home, most often at the hands of an untrained friend or relative, a Dai Training Scheme has been initiated in districts which otherwise report a safe delivery rate of less than 30 per cent. In the current year, 142 districts of 15 States will implement the scheme. All practising Dais and TBAs in these districts will be trained in essentials of care during pregnancy, childbirth and in newborn care over the next two years.

Source: Newborn Health—Key to Child Survival (Present Scenario, Current Strategies and Future Directions for Newborn Health in India), Child Health Division, Department of Family Welfare, Ministry of Health and Family Welfare, GOI

Table 6.6: Childhood vaccinations
Percentage of children aged 12–23 months who received specific vaccinations at any time before the interview and before 12 months of age, by source of information on vaccination history and residence, India, 1998–99 Percentage Vaccinated
Source of Information
BCG
Polio
DPT
Polio

Number of children
1
2
3
1
2
3
Measles
All1
None
URBAN
Vaccinated at any time before the interview
Vaccination card
96.6
33.0
98.9
96.4
91.1
98.5
96.0
90.8
81.0
77.5
0.1
1,048
Mother’s report
78.4
14.9
75.3
69.5
58.3
86.9
83.7
67.5
59.2
46.0
11.7
1,233
Either source
86.8
23.3
86.1
81.9
73.4
92.2
89.4
78.2
69.2
60.5
6.4
2,282
Vaccinated by 12 months of age2
85.1
23.3
83.6
79.1
70.6
89.4
86.1
74.9
59.7
51.9
8.6
2,282
RURAL
Vaccinated at any time before the interview
Vaccination card
94.5
19.8
98.4
91.4
83.0
97.9
91.1
83.0
69.7
65.4
0.1
2,344
Mother’s report
55.3
5.9
53.7
46.6
35.5
73.8
68.0
47.7
34.8
24.3
23.9
5,450
Either source
67.1
10.1
67.1
60.1
49.8
81.1
75.0
58.3
45.3
36.6
16.7
7,795
Vaccinated by 12 months of age2
64.3
10.1
64.4
57.0
46.6
77.5
71.1
54.4
36.2
29.3
20.2
7,795
TOTAL
Vaccinated at any time before the interview
Vaccination card
95.2
23.9
98.6
92.9
85.5
98.1
92.6
85.4
73.2
69.1
0.1
3,393
Mother’s report
59.6
7.6
57.6
50.8
39.7
76.2
70.9
51.3
39.3
28.3
21.6
6,684
Either source
71.6
13.1
71.4
65.0
55.1
83.6
78.2
62.8
50.7
42.0
14.4
10,076
Vaccinated by
12 months of age2
69.1
13.1
68.8
62.1
52.1
80.3
74.6
59.2
41.7
34.5
17.5
10,076

Note: Table includes data only on surviving children from among the two most recent births in the three years preceding the survey

1 BCG, measles, and three doses each of DPT and polio vaccines (excluding polio 0)

2 For children whose information was based on the mother’s report, the proportion of vaccinations given by 12 months of age is assumed to be the same as for children with a written record of vaccination

Source: India, National Family Health Survey (NFHS-II), 1998–99, International Institute for Population Sciences, Mumbai, India

478. The relatively low percentage vaccinated against measles is partly responsible for the low overall percentage (see table 6.7). GOI statistics suggest a much higher level of vaccination coverage than NFHS-II estimates. According to Government statistics for 1997–98, 61 per cent of children aged 12–23 months are fully vaccinated and coverage is 79 per cent for BCG, 73 per cent for the third dose of DPT, 73 per cent for the third dose of polio vaccine, and 66 per cent for measles. Whereas NFHS-II states that 42 per cent of children aged 12–23 months are fully vaccinated and coverage is 72 per cent for BCG, 55 per cent for the third dose of DPT, 63 per cent for the third dose of polio vaccine, and 51 per cent for measles.15

Table 6.7: Childhood vaccinations
Percentage of children aged 12–23 months who received specific vaccinations at any time before the interview (according to the vaccination card maintained the mother) and percentage with a vaccination card that was shown to the interviewer by State, India, 1998–99.
Percentage Vaccinated



DPT
Polio



Region/State
BCG
Polio 0
1
2
3
1
2
3
Measles
All1
None
India North
71.6
13.1
71.4
65.0
55.1
83.6
78.2
62.8
50.7
42.0
14.4
Delhi
92.0
36.9
90.8
88.3
79.9
93.8
91.7
81.0
77.5
69.8
5.1
Haryana
86.8
6.1
89.5
84.5
71.1
90.1
87.4
74.3
72.2
62.7
9.9
Himachal Pradesh
94.6
4.2
96.7
96.1
88.8
97.2
97.2
89.8
89.1
83.4
2.8
Jammu & Kashmir
85.6
4.8
85.7
83.6
72.3
88.3
85.4
74.3
68.9
56.7
10.4
Punjab
88.7
11.2
88.4
87.3
82.0
90.5
88.5
83.6
76.5
72.1
8.7
Rajasthan
53.9
3.2
47.8
40.2
26.1
75.5
67.3
44.6
27.1
17.3
22.5
Central











Madhya Pradesh
64.9
10.1
62.8
52.3
37.0
85.4
79.0
56.7
35.5
22.4
13.9
Uttar Pradesh
57.5
4.7
57.3
46.5
33.9
66.5
60.3
42.3
34.6
21.2
29.5
East











Bihar
37.7
3.6
39.7
33.4
24.2
81.3
71.7
41.0
16.6
11.0
16.8
Orissa
84.7
14.6
80.1
74.8
61.9
88.7
84.8
68.4
54.0
43.7
9.4
West Bengal
76.5
2.1
77.9
70.1
58.3
83.9
76.5
61.7
52.4
43.8
13.6
North-East











Arunachal Pradesh
54.2
4.5
57.4
52.7
41.8
67.6
62.5
43.3
33.6
20.5
28.7
Assam
53.5
3.1
57.4
48.5
37.5
61.8
53.6
37.9
24.6
17.0
33.2
Manipur
71.0
32.1
76.4
71.0
59.1
81.3
76.9
62.5
45.8
42.3
17.2
Meghalaya
46.1
11.5
44.8
36.8
25.4
51.8
43.8
27.6
17.7
14.3
42.3
Mizoram
88.2
4.6
86.9
83.9
69.5
88.3
83.5
71.9
71.0
59.6
10.5
Nagaland
46.1
5.5
48.1
40.9
29.6
66.6
60.3
41.8
19.6
14.1
32.7
Sikkim
76.5
8.2
75.7
71.7
62.5
79.8
75.7
63.5
58.9
47.4
17.6
West Goa
99.2
31.6
97.6
95.2
93.4
99.2
98.4
95.8
84.3
82.6
0.0
Gujarat
84.7
5.3
83.1
75.4
64.1
90.2
82.5
68.6
63.6
53.0
6.6
Maharashtra
93.7
8.3
94.9
91.7
89.4
97.2
94.7
90.8
84.3
78.4
2.0
South











Andhra Pradesh
90.2
5.3
89.8
86.9
79.5
93.8
90.9
81.6
64.7
58.7
4.5
Karnataka
84.8
26.4
87.0
84.8
75.2
91.9
89.0
78.3
67.3
60.0
7.7
Kerala
96.2
60.6
96.0
94.4
88.0
96.9
95.2
88.4
84.6
79.7
2.2
Tamil Nadu
98.6
85.5
98.6
97.5
96.7
99.7
99.5
98.0
90.2
88.8
0.3

Note: Table includes data only on surviving children from among the two most recent births in the three years preceding the survey

1 BCG, measles, and three doses each of DPT and polio vaccines (excluding polio 0)
Source: India, National Family Health Survey (NFHS-II), 1998–99, International Institute for Population Sciences, Mumbai, India

G034386909.jpgFigure 6.5: Childhood vaccinations by region

Source: India Report on the World Summit for Children, 2000, Department of Women and Child Development, Ministry of Human Resource Development, GOI


478. The analysis of vaccine-specific data indicates much higher coverage for each type of vaccine in urban areas than in rural areas. Sixty-one per cent of children aged 12–23 months in urban areas had received all of the recommended vaccinations by the time of the survey, compared with 37 per cent in rural areas. The proportion fully vaccinated during the first year of life is also higher in urban areas (52 per cent) than in rural areas (29 per cent). Dropout rates for both DPT and polio are lower in urban areas than in rural areas. There are considerable interstate differentials in the coverage rates for different vaccinations and for children receiving all vaccinations. The percentage of children who are fully vaccinated ranges from 11 per cent in Bihar to 89 per cent in Tamil Nadu. Among other larger States, Assam (17 per cent), Rajasthan (17 per cent), Uttar Pradesh (21 per cent) and Madhya Pradesh (22 per cent) stand out as having a much lower percentage of fully vaccinated children than the national average of 42 per cent. Since these States account for more than 40 per cent of the total population of the country, their low coverage for vaccination pulls down the coverage rate for the country as a whole. All northern States except Rajasthan, and all southern and western States, have fared relatively well with regard to full coverage of vaccinations. Most of the north-eastern States have a relatively poor record on vaccination coverage. A similar picture emerges with respect to individual vaccinations. Tamil Nadu, Goa, Maharashtra, Himachal Pradesh, and Kerala are approaching universal coverage for BCG and three doses of DPT, and polio. In most States, there is a considerable drop from the second to the third dose for both DPT and polio. The relatively low levels of coverage for measles is also a major factor responsible for failure to achieve full immunisation coverage.16 (see table No. 6.6.)
480. The public sector is the primary provider of childhood vaccination in India. According to NFHS-II survey, 82 per cent of all children who have received any vaccinations received most of them from a public medical source and 13 per cent received them from a private medical source. Children of more educated mothers and those enjoying a high standard of living are more likely to receive vaccinations through private doctors. As with the use of MCH services, there is a strong positive relationship between the mother’s education and childrens’ vaccination coverage. Only 28 per cent children of illiterate mothers are fully vaccinated, compared with 73 per cent children of mothers who have at least completed high school.
481. The UIP was introduced in 1985–86 with the objective of covering at least 85 per cent of all infants against the six vaccine-preventable diseases by 1990, and to achieve self-sufficiency in vaccine production and the manufacture of cold-chain equipment. This scheme has been introduced in every district of the country and the target now is to achieve 100 per cent immunisation coverage.


Polio eradication [Pulse Polio Immunisation (PPI)]

482. The PPI programme was launched in 1995. Under this programme, every child under the age of five years was given oral polio drops in December and January every year, on the same day. To accelerate the efforts for the eradication of polio, PPI programmes have been intensified during 1999–2000. Instead of two rounds, four nationwide rounds and two additional rounds are being conducted in eight States—Assam, Bihar, Gujarat, Madhya Pradesh, Orissa, Rajasthan, Uttar Pradesh and West Bengal. Two national rounds have been completed. Instead of a one-day effort, the campaign is now spread over two to three days. On the first day, immunization is carried out at fixed booth sites, while on the second and third days, the teams make house-to-house visits to immunize the children who have been left out.

Table 6.8: Decline in the reported incidence of diseases
Diseases
1987
1999
2000
% Decline
Polio
28,257
4,320
-
84.7
Wild virus polio
-
-
1126
76
Diptheria
12,952
2,725
-
79.0
Pertussis
1,63,786
36,716
-
77.6
Neonatal tetanus
11,849
4,488
-
62.1
Measles
2,47,519
38,950
-
84.3

Source: Annual Report, 1999–2000, Ministry of Health and Family Welfare, GOI
Surveillance of vaccine-preventable diseases

483. Considerable efforts have gone into developing a reliable surveillance system. Immediate reporting of poliomylitis cases has been made mandatory. There has been a significant decline in the reported incidence of these diseases, compared to 1987 (See table 6.8).

484. Urban Measles Campaign: A special campaign, with assistance from UNICEF, was undertaken to cover slum localities during 1998. Initially, 40 major cities were to be covered. Twenty of these have been identified in 12 States and the remaining 20 will be identified during 1999–2000. The emphasis is on covering all unprotected children up to the age of three years with single doses of the measles vaccine. Based on the experience from these cities, more will be targeted in the coming years.

G034386910.jpg


485. Neo-natal tetanus continues to be a problem in many districts, particularly in the large States. For early elimination of neo-natal tetanus, the Indian Council for Medical Research (ICMR) has advised that efforts be made to immunize all women in the reproductive age group with three doses of tetanus toxoid vaccine, through a campaign approach. On the basis of these recommendations, a plan of action for implementation will be developed for various States. Meanwhile, Rajasthan initiated a campaign in 1998, to cover all married women up to the age of 30 years with three doses of TT.17
486. Continuous investment in the wide-scale availability of vaccines is the most cost-effective intervention that India can make in the foreseeable future. The maintenance and expansion of the UIP to reach every child is the most important foundation for public health, one which will result in lowering mortality and improvement in child survival.


Nutrition

487. Nutritional status is a major determinant of the health and well-being of children. Chronic illness are associated with poor nutrition among children. NFHS-II shows that almost half the children under three years of age (47 per cent) are underweight and a similar percentage (46 per cent) are stunted. The proportion of children who are severely undernourished is 18 per cent according to weight for age and 23 per cent according to height for age. Wasting affects about 16 per cent of children under three years of age.
488. The proportion of children who are undernourished increases rapidly with the child’s age through 12–23 months, where it peaks at 22 per cent for wasting and 58–59 per cent for underweight and stunting. Even during the first six months of life, when 55 per cent of babies are exclusively breastfed, 9–15 per cent of children are undernourished, according to the three nutritional indices. .

Box 6.4: Keep the promises
Evaluation of PPI coverage to validate the reported coverage has become an established practice since the beginning of this initiative. Last year the opportunity of PPI household surveys was utilised to evaluate the Routine Immunisation (RI) coverage countrywide for the first time. Again this year, the same opportunity has been utilised, but instead of three, only one cohort, i.e., children between 12-23 months age, has been assessed for the routine immunisation coverage 1998-99.
On the request of the Ministry of Health and Family Welfare, GOI, UNICEF organised the CES in all the 32 States/union territories and 74 select cities (especially, those with a minimum of 50,000 urban slum population) between February and April 1999.
A total of 29,262 children, i.e., 7,855 children for the state-clusters, 3,749 children for the high-risk-clusters, and 17,658 children for the city-clusters were contacted to assess the routine vaccination coverage. Seventy-five per cent children were from rural clusters and remaining twenty five per cent children were from urban clusters. Distribution by gender revealed that boys were 53.9 per cent to 54.3 per cent and girls were 45.7 to 46.1 per cent. Gender distribution was observed to be in line with the general sex distribution of that age, thereby, indicating that the sample was a fair representation for State, high-risk and city population) children who were contacted for the assessment of routine immunisation only.
Though the coverage results were analysed on the basis of medical history and medical records, the immunisation cards were available, as national average, in 48.5 per cent of the cases. Unfortunately, a decline has been noticed this year in comparison to last year, when it was recorded to be 56 per cent. For high-risk and city clusters the respective percentages were observed to be 42.1 per cent and 44.9 per cent in the current survey. The inter-state variation indicated availability of the immunisation cards to be highest (<85 per cent) in the Union Territories/States of Andaman & Nicobar, Chandigarh, and Tripura. In A & N Islands, Himachal Pradesh, Lakshadweep, and Mizoram the card availability was 91.9 per cent vs 86.7 per cent; 91.5 per cent v 57.5 per cent; 98.7 per cent vs 71.7 per cent; and 98.5 per cent vs 59.1 per cent respectively, for last year vs this year. Less than 50 per cent families showing documentary evidence for the routine vaccination were observed in 12 States/UTs in the current survey.
The situation of availability of immunisation cards among the high-risk population and select cities was similar to the State picture i.e., 42.1 per cent and 44.9 per cent respectively. In the city survey it was 54 per cent last year compared to 44.9 this year.
The question of identifying the availability of routine immunisation services within the clusters indicated that 78.6 per cent of the communities surveyed had services provided within their community. The inter-state variation ranged from 100 per cent in D & N Haveli, Daman and Diu, Gujarat, Kerala and Tamil Nadu to a level of 35 per cent in Assam. It was observed that the service availability at the community level was over 90 per cent in seven States/UTs, between 80 per cent and 90 per cent in eight; between 60 per cent and 80 per cent in another eight; and below 60 per cent in rest of the states/UTs. In high-risk and city, clusters the trend was almost same with an average of 83.6 per cent and 82 per cent clusters having services within their communities, respectively.
This year, the proportion of fully immunised (BCG, OPV3, DPT3 and measles) worked out to be 51 per cent in state clusters (against 61 per cent for 1997-98) for 12-23 month old children, indicating a downward trend. It was observed that only Goa, Maharashtra and Tamil Nadu had sustained coverage level over 80 per cent (against 12 states last year). The picture for fully immunised children in Nagaland (4.2 per cent), Bihar (13 per cent), Arunachal Pradesh (20 per cent), Meghalaya (25 per cent), Pondicherry (25 per cent), Mizoram (26 per cent), Daman and Diu (32 per cent), Assam (34 per cent), Rajasthan (34 per cent), UP (34 per cent) and West Bengal (41 per cent) had been alarmingly low, thereby, needing immediate attention.
The overall picture was found to be similar in high-risk (46 per cent) and city clusters (50 per cent). Only two high-risk clusters (i.e., J&K 81 per cent; and TN 80 per cent) had over 80 per cent fully immunised children this year.
The proportion of fully immunised children among the urban poor population was observed to be sliding down from 73 per cent in 1995-96 to 65 per cent in 1996-97 and 50 per cent in the current year.
Immunisation variables
The immunisation coverage levels are influenced by service availability, service quality, gender discrimination, other socio-cultural restrictions and efforts for demand generation and social mobilisation. Till date, PPI appear to be the country’s most successful public health intervention, as it has been able to mobilise people from all walks of life, thereby, converting it into a people’s programme.
Session in the communities
The availability of sessions within the clusters is indicative of promises kept to provide immunisation services at the community level. The survey indicated availability of service at the community level to be in the range of 35 per cent to 100 per cent (against 23 per cent to 100 per cent last year). It is heartening to know that this year, only in three State clusters it was less than 50 per cent. In five states 100 per cent; in seven between 90 per cent and 99 per cent; in another eight between 80 per cent and 90 per cent; and remaining nine between 50 per cent and 80 per cent clusters had sessions within the communities. The availability of services within the community was better for the high-risk (83 per cent) and urban poor population (82 per cent).
Gender and immunisation
The proportion of fully immunised girls and boys did not show any difference of statistical significance either in favour of male or female child at the national level. Also, there appeared to be no significant gender bias in the coverage of routine vaccinations among the high-risk or urban poor population.
Coverage by religion
This year, the overall national coverage for fully immunised Hindu children declined to 55 per cent from 68 per cent in 1995-96. For Muslims it was 41 per cent (68 per cent in 1995-96), for Christians it was 32 per cent (56 per cent in 1995-96), for Sikhs it was 61 per cent (almost 100 per cent in 1995-96). The decline of proportion of fully immunised coverage levels among other religions were highly significant, i.e., 44 per cent in the current year against 64 per cent in 1995-96 (Ref. RIS10.2B). A similar trend was observed in high-risk and city clusters.
Coverage by caste
The coverage by caste indicated (Ref RIS10.2C, RIH10.2C and RIC10.2C) 45 per cent for SC, 37 per cent for ST and 56 per cent for other children (against 51 per cent for SC, 53 per cent for ST and 65 per cent for others children in 1996-97). The proportion of fully immunised children in 1995-96 was 59 per cent for ST and 72 per cent for other castes.
Immunisation by residence
As expected, urban population had higher coverage because of better access to services and better awareness. The percentage of children who had been completely immunised stood at 58 per cent in urban areas and 48 per cent in rural areas.

Source: Keep the Promises—Evaluation of Routine Immunisation, 1998-99, Ministry of Health & Family Welfare, GOI

489. Between 24–35 months, when most children have been weaned from breast milk, almost one third of children are severely stunted and almost one quarter are severely underweight.
490. Overall, girls and boys are equally likely to be undernourished, but girls are slightly more likely than boys to be underweight and stunted, whereas boys are slightly more likely to be wasted. Undernutrition generally increases with increasing birth order. Young children in families with six or more children are nutritionally the most disadvantaged. First births have lower than average levels of undernutrition on almost all the measures, and children born after a short birth interval are more likely than other children to be stunted or underweight.

491. Malnutrition is substantially higher in rural areas than in urban areas. Even in urban areas, however, more than one third of children are under weight or stunted. Children whose mothers are illiterate are about twice as likely to be under nourished than children whose mothers have completed at least high

Table 6.9: Nutritional status of children
Percentage of children under three years, classified as undernourished on three anthropometric indices of nutritional status, according to State, India, 1998–99
State
Weight for age
Height for age
Weight for height
Percentage below-3 SD
Percentage below-2 SD1
Percentage below-3 SD
Percentage below-2 SD1
Percentage below-3 SD
Percentage below-2 SD
India North
18.0
47.0
23.0
45.5
2.8
15.5
Delhi
10.1
34.7
18.0
36.8
4.1
12.5
Haryana
10.1
34.6
24.3
50.0
0.8
5.3
Himachal Pradesh
12.1
43.6
18.1
41.3
3.3
16.9
Jammu & Kashmir
8.3
34.5
17.3
38.8
1.2
11.8
Punjab
8.8
28.7
17.2
39.2
0.8
7.1
Rajasthan
0.8
50.6
29.0
52.0
1.9
11.7
Central






Madhya Pradesh
24.3
55.1
28.3
51.0
4.3
19.8
Uttar Pradesh
21.9
51.7
31.0
55.5
2.1
11.1
East






Bihar
25.1
54.4
33.6
53.7
5.5
21.0
Orissa
20.7
54.4
17.6
44.0
3.9
24.3
West Bengal
16.3
48.7
19.2
41.5
1.6
13.6
North-East






Arunachal Pradesh
7.8
24.3
11.9
26.5
2.0
7.9
Assam
13.3
6.0
3.7
50.2
3.3
13.3
Manipur
5.3
27.5
11.2
31.3
1.8
8.2
Meghalaya
11.3
37.9
24.5
44.9
1.0
13.3
Mizoram
5.0
27.7
13.9
34.6
2.8
10.2
Nagaland
7.4
24.1
11.7
33.0
2.4
10.4
Sikkim
4.2
20.6
9.7
31.7
0.8
4.8
West






Goa
4.7
28.6
4.8
18.1
0.7
13.1
Gujarat
16.2
45.1
23.3
43.6
2.4
16.2
Maharashtra
17.6
49.6
14.1
39.9
2.5
21.2
South






Andhra Pradesh
10.3
37.7
14.2
38.6
1.6
9.1
Karnataka
16.5
43.9
15.9
36.6
3.9
20.0
Kerala
4.7
26.9
7.3
21.9
0.7
11.1
Tamil Nadu
10.6
36.7
12.0
29.4
3.8
19.9

Note: Each index is expressed in standard deviation units (SD) from the median of the International Reference Population
Includes children who are below-3 SD from the International Reference Population Median
Source: India, National Family Health Survey (NFHS–II), 1998–99, International Institute for Population Sciences, Mumbai, India

school and the differentials are even larger in the case of severe malnutrition. Inadequate nutrition is a problem throughout India, though the situation is considerably better in some States. Table 6.9 shows that undernutrition is most pronounced in Bihar, Madhya Pradesh, Karnataka, and Tamil Nadu — all characterized by high levels of wasting among children. Nutritional problems are least evident in Sikkim, Arunachal Pradesh, Goa and Kerala. Even in these States, however, levels of undernutrition are unacceptably high.18


Infant feeding practices

492. Infant feeding practices have significant effects both on mothers and children. Proper infant feeding, starting from the time of birth, is important for the physical and mental development of the child. Breastfeeding improves the nutritional status of young children and reduces morbidity and mortality. Breast milk not only provides important nutrients but also protects the child against infection. Although breastfeeding is nearly universal in India, only 16 per cent of infants are put to the breast immediately after birth and 37 per cent within the 1st day. According to NFHS–II, only 55 per cent of children under four months of age are exclusively breastfed in India; 23 per cent receive breast milk plus water and 20 per cent receive supplements along with breast milk.
493. From about six months of age, the introduction of complementary food is critical for meeting the protein, energy, and micro-nutrient needs of children. However, in India the introduction of complementary food is delayed for a substantial proportion of children. Only 24 per cent of breastfeeding children who are six months old consume solid and mushy foods. This proportion rises to only 46 per cent at 9 months of age. Even at twelve months of age, more than one-quarter of breastfeeding children do not eat any solid or mushy food. Only 35 per cent of breastfeeding children aged 6-9 months receive solid or mushy food as recommended.19
494. . NFHS-II estimates that 11.9 per cent of children (0-6 months), 37.5 per cent of children (6-11 months), 58.5 per cent of children (12-23 months) and 58.4 per cent of children (24-35 months) were underweight (children who are more than two standard deviations below the reference median).20


Micro-nutrient deficiency
Iodine

495. Iodine is an important micro-nutrient. Lack of iodine in the diet can lead to iodine deficiency disorders (IDD), which according to the World Health Organization (WHO) can cause miscarriages, brain disorders, cretinism, and retarded psycho-motor development. Iodine deficiency is the single most important and preventable cause of mental retardation worldwide. It has been estimated that 200 million people in India are exposed to the risk of iodine deficiency and 70 million suffer from goitre and other IDDs (IDD and Nutrition Cell, 1998). In addition, about one fifth of pregnant women are at considerable risk of giving birth to children who will not reach their optimum physical and mental potential because of material iodine deficiency (Vir, 1995).
496. Iodine deficiency can be avoided by using salt that has been fortified with iodine. In 198384, the GOI adopted a policy to achieve universal iodisation of edible salt by 1992 and advised all States and UTs to issue notifications banning the sale of edible salt that was not iodized. All but one State issued a full or partial ban. A national ban was instituted in 1997, but was lifted in September 2000.
497. Despite Government regulations in effect at the time of NFHS–II, only 49 per cent of households used cooking salt that was iodized at the recommended level of 15 ppm or more. Differentials in usage of iodized salt by background characteristics were pronounced. Seventy-seven per cent of households in large cities use salt with 15 ppm or more of iodine, compared with 67–68 per cent of households in small cities and towns, and only 42 per cent of households in rural areas. The use of iodized salt is relatively low in households headed by persons from Scheduled Castes (41.8 per cent), Scheduled Tribes (43.3 per cent), or Other Backward Classes (42.4 per cent). The widest differentials are observed for the standard of living index. Seventy- eight per cent of households with a high standard of living use adequately iodized salt compared with only 35 per cent of households with a low standard of living.
498. The use of iodized salt varies dramatically from one State to another, being lowest in the two States (Tamil Nadu and Rajasthan) that produce salt (see table 6.10). The variations are due to a number of factors, including the scale of salt production, transportation requirements, enforcement efforts, the pricing structure, and storage patterns. In particular, salt iodization is likely to be more common in States where salt is transported exclusively by railways, at least partly because the Salt Department monitors the iodine content of salt shipped by railways.21


Iron

499. Anaemia can prove serious for young children because it can result in impaired cognitive performance, impact behavioural and motor development coordination, language development, and scholastic achievement, as well as cause increased morbidity from infectious diseases (Seshadri, 1997). One of the most vulnerable groups is children aged 6–24 months (Stoltzfus and Dreyfuss, 1998).
500. NFHS–II shows that overall, nearly three-quarters (74 per cent) of children aged 6-24 month have some level of anaemia, including 23 per cent who are mildly anaemic (10.0–10.9 g/dl), 46 per cent who are moderately anaemic (7.0–9.9 g/dl), and five per cent who are severely anaemic (less than 7.0 g/dl). Notably, a much larger proportion of children than women are anaemic and the difference is particularly pronounced in the case of moderate to severe anaemia.
501. Several groups of children have particularly high levels of anaemia. These include children aged 12–23 months (77.7 per cent as per NFHS-II), children of higher birth orders (78.4 per cent as per NFHS-II), rural children (75.3 per cent as per NFHS-II), children whose mothers are illiterate (78.2 per cent as per NFHS-II), children of SCs (78.3 per cent as per NFHS-II) and STs (79.8 per cent as per NFHS-II), and children from poor families (78.7 per cent as per NFHS-II). As expected, there is a strong positive relationship between the haemoglobin levels of mothers and prevalence of anaemia among children. Almost one quarter of children whose mothers are severely anaemic are severely anaemic themselves.
502. Table 6.11 shows the levels of anaemia by State. Nagaland, Kerala and Manipur are the only States where less than half the children are anaemic. The highest prevalence of anaemia is found in Haryana, Rajasthan, Bihar, and Punjab, where at least 80 per cent of children are anaemic. In these four States, 54–66 per cent of children are moderately or severely anaemic.22


Vitamin A deficiency

503. The National Programme on Prevention of Blindness (NPPB) targets children under five years and is supposed to administer oral doses of vitamin A, every six months, starting after six months of birth. However, overall 29.7 per cent of children between one and three years have received one dose, and 17 per cent have received a dose in the last six months. Children living in urban areas (38.7 per cent as per NFH-II), children of more educated mothers (47.0 per cent as

Table 6.10: Iodisation of salt by state
Per cent distribution of households by degree of iodisation of salt, according to State, India, 1998–98
State
Not iodised
7 ppm
15 ppm
30 ppm
Missing
Total Per cent
India
28.4
21.6
16.8
23.6
0.7
100.0
North






Delhi
6.1
4.5
13.5
75.7
0.1
100.0
Haryana
19.5
9.2
13.9
57.1
0.2
100.0
Himachal Pradesh
3.2
6.2
14.9
75.6
0.1
100.0
Jammu & Kashmir
24.8
22.3
27.5
25.4
0.0
100.0
Punjab
16.7
7.8
13.7
61.6
0.3
100.0
Rajasthan
37.1
15.3
21.9
24.4
1.3
100.0
Central






Madhya Pradesh
25.0
16.3
14.4
42.3
2.1
100.0
Uttar Pradesh
22.7
26.9
19.6
29.2
1.6
100.0
East






Bihar
22.9
30.1
26.6
20.4
0.0
100.0
Orissa
29.6
35.1
18.2
16.8
0.4
100.0
West Bengal
11.3
26.5
25.8
36.0
0.5
100.0
North-East






Arunachal Pradesh
0.8
15.0
46.9
37.2
0.1
100.0
Assam
1.8
18.2
32.7
46.9
0.3
100.0
Manipur
2.3
9.7
15.4
72.5
0.1
100.0
Meghalaya
6.7
30.0
24.9
38.1
0.3
100.0
Mizoram
0.7
8.0
27.9
63.3
0.0
100.0
Nagaland
10.9
21.2
25.5
41.7
0.7
100.0
Sikkim
3.1
17.5
31.8
47.3
0.3
100.0
West






Goa
37.3
20.2
4.0
37.9
0.6
100.0
Gujarat
29.5
14.2
14.9
41.2
0.2
100.0
Maharashtra
32.0
6.9
11.0
49.1
1.0
100.0
South






Andhra Pradesh
36.8
35.7
10.2
17.2
0.1
100.0
Karnataka
24.1
32.4
12.9
30.5
0.1
100.0
Kerala
47.6
13.2
5.6
3.7
0.0
100.0
Tamil Nadu
62.7
15.8
8.1
13.1
0.3
100.0

Source: India, National Family Health Survey (NFHS–II), 1998–99, International Institute for Population Sciences, Mumbai, India

Table 6.11: Anaemia among children
Percentage of children aged 6-35 months classified as having iron-deficiency anaemia by State, India, 1998–99.
Percentage of children
Percentage of children with:
State
anaemia
Mild anaemia
Moderate anaemia
Severe anaemia
India
74.3
22.9
45.9
5.4
North
Delhi
69.0
22.2
42.9
3.9
Haryana
83.9
18.0
58.8
7.1
Himachal Pradesh
69.9
28.7
39.0
2.2
Jammu & Kashmir
71.1
29.1
38.5
3.5
Punjab
80.0
17.4
56.7
5.9
Rajasthan
82.3
20.1
52.7
9.5
Central
Madhya Pradesh
75.0
22.0
48.1
4.9
Uttar Pradesh
73.9
19.4
47.8
6.7
East
Bihar
81.3
29.6
50.3
4.1
Orissa
72.3
26.2
43.2
2.9
West Bengal
78.3
26.9
46.3
5.2
North-East Arunachal Pradesh
54.5
29.1
24.7
0.7
Assam
63.2
31.0
32.2
0.0
Manipur
45.2
22.6
21.7
0.9
Meghalaya
67.6
23.4
39.8
4.3
Mizoram
57.2
32.2
22.7
2.3
Nagaland
43.7
22.0
18.7
3.0
Sikkim
76.5
28.4
40.7
7.5
West
Goa
53.4
23.5
27.9
2.0
Gujarat
74.5
24.5
43.7
6.7
Maharashtra
76.0
24.1
47.4
4.4
South
Andhra Pradesh
72.3
23.0
44.9
4.4
Karnataka
70.6
19.6
43.3
7.6
Kerala
43.9
24.4
18.9
0.5
Tamil Nadu
69.0
21.9
40.2
6.9

Note: Haemoglobin levels are adjusted for altitude when calculating the degree of anaemia

Source: India, National Family Health Survey (NFHS–II), 1998–99, International Institute of Population Science, Mumbai, India

Table 6.12: Vitamin A supplementation for children
Percentage of children aged 12–35 months who received at least one dose of vitamin A and who received at least one dose of vitamin A within the six months preceding the survey by State, India, 1998–99.
State
Percentage who received vitamin A
At least one dose
At least one dose within the past six months
India
North
29.7
17.1
Delhi
32.7
17.4
Haryana
45.2
21.4
Himachal Pradesh
71.1
35.1
Jammu & Kashmir
36.0
32.8
Punjab
56.5
30.2
Rajasthan
17.6
12.5
Central


Madhya Pradesh
24.4
14.7
Uttar Pradesh
13.9
9.5
East
Bihar
10.2
6.8
Orissa
42.0
26.4
West Bengal
43.4
23.5
North-East


Arunachal Pradesh
20.9
9.6
Assam
15.4
8.9
Manipur
38.4
18.8
Meghalaya
24.7
10.7
Mizoram
70.6
41.8
Nagaland
6.8
4.4
Sikkim
45.8
22.0
West
Goa
78.0
52.3
Gujarat
51.1
26.3
Maharashtra
64.7
36.6
South
Andhra Pradesh
24.8
14.0
Karnataka
48.4
22.8
Kerala
43.6
28.2
Tamil Nadu
16.2
10.0

Note : Table includes only surviving children from among the two most recent births in the three years preceding the survey

Source: India, National Family Health Survey (NFHS–II), 1998–99, International Institute of Population Sciences, Mumbai, India

per NFHS-II), and children in households with a high standard of living (43.3 per cent as per NFHS-II) are considerably more likely than other children to receive vitamin A supplementation. Similarly, children from SC (27.1 per cent as per NFHS-II), ST (26.0 per cent as per NFHS-II), and OBC households (26.8 per cent as per NFHS-II) are less likely to receive vitamin A than other children. As is the case with immunisations, boys have a slight edge in vitamin A coverage. In general, children from groups that are less likely to have received at least one dose of vitamin A supplementation are also less likely to have received a dose in the past six months.
504. State variations in the percentage of children (one to three years) who received at least one dose of vitamin A and the percentage who received at least one dose within six months are shown in table 6.12. The percentage of children aged 12–35 who received at least one dose of vitamin A supplementation ranges from seven per cent in Nagaland to 78 per cent in Goa. In addition to Nagaland, Bihar (10 per cent), Uttar Pradesh (14 per cent) Assam (15 per cent), Tamil Nadu (16 per cent), and Rajasthan (18 per cent) stand out as having very low proportions of children receiving at least one dose of vitamin A. In addition to Goa, Himachal Pradesh (71 per cent) and Maharashtra (65 per cent) stand out as having relatively successful vitamin A supplementation programmes. State variations in the percentage of children receiving at least one dose of vitamin A supplementation within the past six months follow closely the variation in the percentage of children receiving at least one dose at any time in the past.23
505. The Food and Nutrition Board (FNB), a non-statutory ministerial wing of the Department of Women and Child Development (DWCD) is engaged in conventional activities as well as new initiatives undertaken as a follow-up to the National Nutrition Policy. Nutrition education of the people in rural, urban and tribal areas is one of the primary activities of the FNB. A total of 9,310 nutrition demonstration programmes were organised from April–December 1999. Of these, 8,405 were in rural areas and 4,152 for SC/ST communities. About 0.415 million people, comprising mainly women, benefited from these programmes. As many as 42.8 per cent of these belonged to the SC/ST community. Nutrition orientation of grassroot level functionaries and their supervisors is undertaken by organizing Integrated Nutrition Education Camps (INECs) and Orientation Training Courses (OTCs), with a view to utilizing the existing infrastructure of the Government to impart basic nutrition messages to the community.
506. The FNB strives to create nutritional awareness through mass media communications as well. Video films and spots, developed and produced in regional languages, are provided to the regional centres of Doordarshan (official television channel) for telecast. Considering the vast outreach of radio, this medium of communication has also been well utilised by the FNB for creating mass awareness in nutrition. Video spots and radio spots on infant nutrition have been developed during 1999–2000. A radio-sponsored programme, Poshan aur Swasthya (Nutrition and Health), with 30 episodes on various aspects of nutrition, has been prepared and is being launched shortly. The programme will be relayed through 30 commercial broadcasting stations of All India Radio (AIR) in 12 regional languages in the country.
507. The nationwide celebration of important events like National Nutritional Week, involving all the supporting agencies, through Doordarshan, AIR and leading newspapers; organizing melas (fairs)/exhibitions, films and slide shows on nutrition education; relaying programmes on television and AIR; and arranging press coverage of integrated nutrition education programmes for wider coverage are some of the important strategies adopted for creating nutritional awareness among the masses. The XVIII National Nutritional Week was observed throughout the country during 1–7 September, 1999, on the theme of “Preventing Malnutrition among Children under Two Years”. The theme for the year 2000 was “Malnutrition-An Obstacle to National Development..” The support of the State Governments, educational institutions and NGOs was received. World Breastfeeding Week was observed on 1-7 August, 1999, on the global theme of “Breastfeeding—Education for Life”, throughout the country. The theme for the year 2000 was “Breastfeeding is Your Right”. In collaboration with the Breastfeeding Promotion Network of India (BPNI), State Governments, NGOs and home science colleges participated, and 869 demonstrations, 221 exhibitions, 184 film and slide shows and 287 other functions, including workshops, discussions, and essay and drawing competitions, were organized by the FNB.
508. The community-based production of nutritious food, involving NGOs and women’s groups, has been an important intervention for meeting the nutritional needs of children and women. Twelve such units were set up during 1993–97, with one-time financial assistance. These units produce low-cost nutritious food at the community level, for use in supplementary feeding programmes. The fortification of common foods with vital nutrients is one of the fastest and most effective methods to ensure adequate nutrition. In the past, the FNB undertook programmes which included the fortification of wheat flour with soya flour, the fortification of modern bread with lysine/soya flour, and the fortification of salt with iron.24
509. At present, 32 dairies in the country fortify milk with vitamin A. Efforts are also being made to mobilize the Department of Animal Husbandry and Dairying to take up fortification of all toned and double-toned milk in the country through the network of cooperative dairies. Efforts are also in progress to explore the possibility of fortifying wheat flour with iron and folic acid.25
510. The Food and Nutrition Council was constituted in November 1997. A draft National Nutrition Mission is under preparation. It will aim to eradicate malnutrition in a time-bound fashion. The three important areas of action will be:

511. Andhra Pradesh, Arunachal Pradesh, Chandigarh, Himachal Pradesh, Maharashtra, Meghalaya, Manipur, Rajasthan, Sikkim and West Bengal have constituted State-level Nutrition Councils and inter-departmental committees. Tamil Nadu and Gujarat have formulated State Nutrition Policies. Karnataka, Madhya Pradesh and Uttar Pradesh are finalizing State Plans of Action on Nutrition.26
512. A pilot project to control micronutrient deficiency was launched in 1995 by DWCD, with the objective of assessing the magnitude of fluorosis, including dental caries and to prevent and control zinc deficiency at source, and assessing and improving the iron and vitamin status of schoolchildren. The programme is being implemented in one district each in five States—Assam, Bihar, Orissa, Tripura, Karnataka and West Bengal. An integrated project on micro-nutrient malnutrition control is to be implemented in West Bengal and Gujarat with financial assistance from Micro-nutrient Initiative (MI). The State Governments propose to cover the most vulnerable groups of the population namely, 0–2 year olds, adolescent girls, pregnant and lactating mothers.27
513. District nutrition profiles of 187 districts, included in the India Nutritional Profile, 1998, have been circulated widely to various States and organizations with the request to focus their development programmes on high-malnutrition districts.
514. The Department coordinated the development of a national strategy for reducing childhood malnutrition in the country under the Regional Assistance Programmes of the Asian Development Bank and UNICEF. The report has identified female illiteracy, early marriages, teenage pregnancies and lack of nutritional awareness as some important determinants of malnutrition.28
515. The Nutrition Cell in the Directorate General of Health Services under the MOHFW, provides technical advice on all matters related to policy making, programme implementation and evaluation, training content for different levels of medical and paramedical workers, standards and labels for food, project evaluation, etc. The Cell also coordinates the activities of the State Nutrition Divisions (presently in 17 States and UTs). These are responsible for conducting diet and nutrition surveys and in imparting training to different categories of health workers who are involved in imparting nutrition education to the masses.29
516. In 1981, the World Health Assembly adopted an International Code on the Marketing of Breast Milk Substitutes. The GOI recognized this Code and adopted the Indian National Code for Protection and Promotion of Breastfeeding in December 1983. To give effect to the provisions of this Code, the Infant Milk Substitutes, Feeding Bottles and Infant Foods (Regulation of Production, Supply and Distribution) Act, 1992, came into force with effect from August 1993. The Act provides for the regulation of production, supply, distribution and marketing of infant milk substitutes, feeding bottles and infant foods with a view to protecting and promoting breastfeeding and ensuring the proper use of infant foods and for matters in connection therewith or incidental thereto. The rules framed under the Act also came into force with effect from August 1993. In addition to food inspectors appointed under the PFA Act, the Central Government authorised the four voluntary organisations—Central Social Welfare Board, Indian Council for Child Welfare, Association for Consumer Action of Safety and Health and the Breastfeeding Promotion Network of India— engaged in the field of child welfare and development and child nutrition to make complaints in writing against violations of the Act.

Box 6.5: Preventing malnutrition in Rajasthan
The 20th year of ICDS focused attention on the need to reach the younger child and prevent malnutrition through the strengthened integration of health and ICDS, using immunisation contact points with pregnant women and mothers of infants. A series of nationwide joint planning and mobilisation activities at the State, district and project levels were initiated to specifically promote complementary feeding and diarrhoea management. Rajasthan conducted an Intensive Village Contact Drive. Over 480 Gram Sampark Samoohs (village contact teams/VCTs) were constituted sector-wise to cover AWCs in 11 districts of Jaipur and Ajmer divisions. The team comprised four members—the Sector Supervisor; Pracheta or Gram Sevika, wherever available, representatives of local voluntary organisations/Nehru Yuvak Kendra; and a folk artist.
At the village level, activities were coordinated by the VCTs together with a local resource group consisting of the AWW, ANM, panchayat member, women leaders, Bal Vikas Samiti members. The activities conducted include:
Prabhat Pheris by children in the 6–14 years age group;
Slogan writing by primary schoolchildren;
Enumeration of children under two years of age;
Village mapping for identifying households with sick/malnourished children;
Demonstration of preparation of complementary foods for children;
Hand washing and hygiene practices;
Testing of salt for iodine content;
Preparation of ORS solution;
Showing and discussing use of IFA tablets, vitamin A solutions, etc.,
Weighing of children below two years of age and growth promotion; and
Use of folk media/puppet with all these messages.

Source: Integrated Child Development Services, Department of Women and Child Development, Ministry of Human Resource Development, GOI.

517. Efforts in this direction make India one of the leading countries with regard to legislations to protect, promote and support breastfeeding. As per the 1997 UNICEF report on the Progress of Nations, India is one of 16 countries in the world to have enacted legislations to implement the International Code on the Marketing of Breastmilk Substitutes in entirety. The GOI was awarded, during 1998, with the “Hopeful Baby Award” by the United Kingdom Food Group for imaginative and effective implementation of WHO/UNICEF International Code on Marketing of Breastmilk Substitutes. This is, indeed, a recognition of the efforts made by the Government. In order to check marketing malpractices in the sale and promotion of infant foods, efforts are under way to further strengthen the Act.30


Common childhood ailments

518. Every year, some 12 million children in developing countries die before they reach their fifth birthday, many during the first year of life. Seven out of 10 of these deaths are due to acute respiratory infection (mostly pneumonia), diarrhoea, measles, malaria or malnutrition—or a combination of these conditions.


Acute Respiratory Infection (Pneumonia)

519. Acute respiratory infection is a leading cause of death among infants and young children in India. According to NFHS-II, 19 per cent of children under three years in India suffered from ARI (cough accompanied by short, rapid breathing). ARI is more common among boys than girls and among rural children than urban. The prevalence of ARI is higher among ST children than among other children, and children in households with a lower standard of living. The smaller variation in prevalence of ARI by most socio-economic characteristics indicates that respiratory infections affect children from all strata in India irrespective of the socio-economic background. There is, however, considerable variation in the prevalence of ARI by State (See Table 6.13). The percentage of children under three years who suffered from ARI ranges from eight per cent in Karnataka to 30 per cent in Sikkim. Diagnosis of ARI in children—if done early—can be treated immediately with antibiotics, and a substantial proportion of children can be saved from death. It is estimated that one-fifth of children with ARI receive no treatment.
520. The ARI Control Strategy of the Ministry of Health and Family Welfare was developed during 1989 and has now become a part of the RCH programme. Health workers have been imparted training in ARI management. Cotrimoxazole is being supplied to health workers through the CSSM kit. Communication messages focus on recognition of symptoms, and referrals are channelled through mothers’ meeting, inter-personal communication with ANMs and other sectors such as ICDS.


Fever

92. According to NFHS-II, 30 per cent of children suffer from fevers. The prevalence of fever is lower among children under six months (21 per cent) than among older children (28–34 per cent). In general, the prevalence of fever does not vary widely or in a predictable way with most of the remaining demographic and socio-economic characteristics. Fever tends to strike young children irrespective of the demographic and socio-economic background. The prevalence of the fever varies from 21 per cent in Gujarat to 42 per cent in Kerala. For more details see Table 6.13.


Diarrhoea

522. Diarrhoea is the second most important killer of children under five years, after ARI. Deaths from acute diarrhoea are most often caused by dehydration due to loss of water and electrolytes. Nearly all dehydration-related deaths can be prevented by prompt administration of rehydration solutions. Among children aged 1–35 months, those aged 6–11 months are most susceptible to diarrhoea (as is the case with ARI and fever). Differentials by sex of child, birth order, place of residence, and caste/tribe are small. Also, consistent with expectations, diarrhoea is somewhat less common among children living in households that boil water or use a water filter for purification of drinking water, than among other children. Children living in households that use surface water for drinking are more vulnerable to diarrhoea than children living in households that use other sources for drinking water.

Table 6.13: Prevalence of acute respiratory infection, fevers and diarrhoea
Percentage of children under three years who were ill with a cough accompanied by rapid breathing (symptoms of ARI), fever or diarrhoea during the two weeks preceding the survey and percentage with ARI who were taken to a health facility or provider by State, India, 1998–99.

Cough accompanied by rapid breathing (ARI)
Fever
Any diarrhoea1
Diarrhoea with blood
India
19.3
29.5
19.2
2.6
North
Delhi
16.9
35.7
30.1
1.6
Haryana
11.8
23.7
13.9
1.8
Himachal Pradesh
10.8
29.9
31.3
4.5
Jammu & Kashmir
22.2
39.4
32.8
4.1
Punjab
14.4
24.9
9.8
0.6
Rajasthan
22.0
25.8
19.8
3.4
Central
Madhya Pradesh
29.2
31.0
23.4
4.3
Uttar Pradesh
21.1
27.8
23.3
3.8
East
Bihar
21.7
31.0
17.7
2.9
Orissa
22.5
36.0
28.1
4.5
West Bengal
24.8
29.9
8.3
1.0
North-East
Arunachal Pradesh
25.4
38.5
23.4
3.0
Assam
17.8
28.4
8.2
2.2
Manipur
26.9
36.8
16.6
4.1
Meghalaya
28.8
41.2
21.8
6.1
Mizoram
11.2
35.9
23.0
3.5
Nagaland
18.4
34.0
21.7
2.6
Sikkim
30.0
31.3
31.0
2.5
West
Goa
17.1
34.4
18.7
0.6
Gujarat
11.0
20.7
19.7
1.3
Maharashtra
13.5
37.4
25.4
1.7
South
Andhra Pradesh
19.3
28.6
15.0
1.5
Karnataka
7.9
25.9
13.9
0.7
Kerala
22.8
41.5
11.6
0.9
Tamil Nadu
10.3
22.3
14.4
1.7

Note : Table includes only surviving children aged 1–35 months from among the two most recent births in the three years preceding the survey

1 Includes diarrhoea with blood

Source: India, National Family Health Survey (NFHS-2), 1998-99, International Institute of Population Sciences, Mumbai, India

523. Three per cent of all children aged 1–35 months suffered from diarrhoea with blood, a symptom of dysentery. Children under six months had the lowest prevalence of diarrhoea with blood (less than one per cent). Children of birth order four or higher, children living in rural areas, children whose mothers are illiterate, ST children, children in households with a low standard of living, children living in households using surface water for drinking and children living in households using other means of water purification or using unpurified water for drinking, all had an increased risk of having diarrhoea with blood. Prevalence of diarrhoea also varies considerably by State (table 6.13). Prevalence of any diarrhoea among children aged 1–35 months during the two weeks preceding the survey ranged from eight per cent in Assam and West Bengal to 33 per cent in Jammu & Kashmir. Prevalence of diarrhoea with blood was highest in Meghalaya (six per cent).31
524. The Oral Rehydration Therapy (ORT) programme of the MoHFW was started in 1986–87, with the objective of preventing death due to dehydration caused by diarrhoeal diseases among children under five years of age. Oral Rehydration Solution (ORS) has been used as a drug of choice for proper management of diarrhoea. To make ORS packets widely available, States have been advised to market ORS packets through the public distribution system. A national standard for ORS has also been developed. Since diarrhoea is also a major cause of malnutrition among children, adequate nutritional care of the child with diarrhoea and proper advice to mothers on feeding are two important thrust areas of this programme.
525. The proportion of infants dying of diarrhoeal diseases has been decreasing all over the country. Efforts to educate parents and health workers through new, more community-oriented approaches about the use of ORS and the need for increased fluids and feeding during diarrhoea need to be stepped up to reach those whose knowledge remains low. With a ready supply of ORS available 24 hours a day at a depot in each community—rural and urban—and the widespread knowledge and belief by parents and health workers alike, that this is indeed a life-saving technology, deaths from diarrhoea could be reduced by a substantial 60–70 per cent.


Other programmes

National TB Control Programme.

527. Tuberculosis continues to remain one of the most pressing health problems in India. It is estimated that 50,000 children under five years of age die of childhood TB every year.33 India launched the National Tuberculosis Control Programme (NTCP) in 1962 which was integrated with the Primary Health Care Delivery System and is implemented through District Tuberculosis Centres (DTC), of which 446 have been established. In addition, there are 47,600 TB beds in the country, 330 TB clinics in urban areas and 17 State TB Training and Demonstration Centres.34


National Programme for Control of Blindness

528. The National Programme for Control of Blindness (NPCB) was launched in 1976. Various activities of the programme include establishment of Regional Institute of Ophthalmology, upgradation of medical colleges and district hospitals and block-level Primary Health Centres, development of mobile units, and recruitment of required ophthalmic manpower in eye-care units for provision of various ophthalmic services. The programme also extends assistance to voluntary organizations for providing eye-care services, including cataract operations and eye-banking. The goal was to reduce the prevalence of blindness from 1.4 per cent to 0.3 per cent by 2000.
529. Voluntary organizations are playing an important role in this programme. With the success achieved and experience gained through the pilot districts, District Blindness Control Societies (DBCS) have been established throughout the country. To date, 512 DBCS have been established.
530. An agreement was signed between the GOI and the Government of Denmark to provide support for the development of services under NPCB.
531. A World Bank-assisted Cataract Blindness Control Project is under implementation since 1994-95 at an estimated cost of Rs 554 crore for seven years in the States of Andhra Pradesh, Madhya Pradesh, Maharashtra, Orissa, Rajasthan, Tamil Nadu and Uttar Pradesh. Major inputs of the project are upgrading the ophthalmic service, expanding the coverage in rural and tribal areas, establishment and functioning of DBCS, training ophthalmic manpower, improving the management information system and creating awareness about the programme among the masses.
532. A mid-term review of the project was undertaken during 1988 to assess the progress through rapid assessment survey, facility survey and beneficiary assessment survey. The surveys were conducted by independent organizations to find out the level of prevalence, outcome of surgery, coverage and satisfaction of beneficiaries, their knowledge, attitude and practices for eye-care and quality of life after surgery.35
533. Other serious health problems which affect children are kala-azar, which is prevalent in Bihar and West Bengal, predominantly in the districts adjoining the Ganges river. Japanese encephalitis is a serious public health problem, which has been reported from 24 States and UTs. Outbreak of dengue fever has been reported from various parts of the country, primarily from urban areas.
534. Varumun Kappom (prevent it before it comes), a campaign approach to health care was launched at sub-centre level for 5000 population groups, by the Government of Tamil Nadu. A comprehensive health check-up by a team of doctors, including specialists, was taken up by the Government. A separate director and special officer were appointed to monitor the implementation of the programme. Early detection of congenital deformities/diseases like rheumatic heart diseases, leprosy and anaemia and referrals for treatment of the same were also undertaken. Access to information on personal environmental and hygiene, as well as nutrition education were also made available.36
535. The Government of Tamil Nadu initiated the special health check-up for primary school students in 1965. It basically aims at screening all schoolchildren for common ailments, referral of children with problems to health institutions for full check-up and treatment, and creating awareness among community and teachers about health problems among children. The programme Vazhvoli Thittam has been revamped and is aimed at early detection of disabilities among schoolchildren.37
536. Other innovative programmes include a radio programme for adolescent listeners in the districts covered under the DANIDA project.38


Family planning

537. The National Family Welfare Programme in India has traditionally sought to promote responsible and planned parenthood through voluntary and free choice of family planning methods, best suited to individual acceptors. With regard to family planning, the new approach emphasizes target-free promotion of contraceptive use among eligible couples, the provision to couples of a choice of contraceptive methods and the assurance of high quality care. An important component of the programme is the encouragement of adequate spacing of births, with an attempt to ensure three years of spacing.
538. The new National Population Policy (NPP), 2000, adopted by the GOI, has set as an immediate objective the task of addressing the unmet need for contraception in order to achieve the medium-term objective of bringing the Total Fertility Rate (TFR) down to replacement level by the year 2010.
539. Family planning methods and services in India are provided primarily through a network of Government hospitals and urban family welfare centres in urban areas and PHCs and Sub-centres in rural areas. Family planning services are also provided by private hospitals and clinics as well as NGOs. Sterilization and IUD insertion are carried out mostly in Government hospitals and PHCs. Modern spacing methods such as IUD, the pill and condoms are available through both the Government and the private sector. It is expected that since levels of urbanization and education in India are rapidly increasing, reliance on private sector services is likely to expand in future.
540. For many years, family planning programmes have been using the electronic and other mass media to promote family planning. Studies have confirmed that even after controlling the effect of residence and education, exposure to the electronic mass media has a substantial effect on contraceptive use. Results indicate that messages disseminated through the mass media reach 60 per cent of ever-married women in India. The most common source of family planning messages is television. Forty-four per cent of ever-married women report having seen a family planning message on television, followed by radio (38 per cent), wall painting or hoarding (31 per cent), newspapers and magazines (18 per cent), and cinema/film shows (13 per cent). Only four per cent were exposed to a message through drama, folk dance, or street play. Eighty-three per cent of urban ever-married women report seeing or hearing a family planning message from at least one media source as compared to 52 per cent of women in rural areas. Urban women are more likely than rural women to have been exposed to a message through each form of mass media.39 Forty-three per cent of current users of a modern method of contraception said that they adopted a method on their own. It can be presumed that the widespread exposure to family planning messages has led to this. Twenty-one per cent of current users said that a Government health worker had motivated them. The role of Government workers in motivating users in rural areas is particularly important.
541. The findings of NFHS–II on fertility and family planning have recorded implications for programme intervention on family planning. Although the TFR has come down from 3.4 to 2.9 per cent, current fertility continues to be characterized by considerable amount of child bearing. Fertility declines sharply with women’s education. The TFR for women who have completed at least high school is 2.0 compared with TFR of 3.5 children for illiterate women. If women were to have the number of children they wanted, the TFR would be 2.1. This suggests that if women are helped to meet their own desired family size goals, the family planning programme can successfully meet the objective of replacement level fertility. However, son preference continues to play an important role in fertility levels.
542. Knowledge of contraception is nearly universal, with the highest knowledge being about female and male sterilization, followed by the pill, the condom and IUDs. However, knowledge about the last three methods is particularly low in Andhra Pradesh, Madhya Pradesh and Orissa. Contraceptive prevalence varies across States, from 67–68 per cent in Himachal Pradesh, Punjab and West Bengal to 20–30 per cent in Bihar and Uttar Pradesh. Female sterilization is the single most popular method in every State. The public medical sector is the source of contraceptives for 76 per cent of all users of modern contraceptives, while the share of the private medical sector is 17 per cent. The private medical sector and shops, however, are the main source for three out of four users of pills and condoms.
543. Sixteen per cent of currently married women in India have an unmet need for family planning, that is, they are not using contraception even though they do not want any more children, or they want to wait for at least two years before their next child. The unmet need for family planning has fallen since NFHS-I, which it was 20 per cent at that time.
544. A major criticism of the family planning programme in India has been that it has always emphasized the role of the woman. Female sterilization is much higher than male sterilization and use of IUDs and the pill is higher than that of condoms. In fact, family planning is seen as the responsibility of the woman/mother and not of the man/father. This lack of responsibility in sexual behaviour and in matters of conception and contraception by men has been identified as a major area of concern requiring change in male sexual behaviour and acceptance of male contraceptives.
545. Gender bias in health care-seeking behaviour is extremely pronounced. Extended periods of childbearing exist in several high fertility States. These States also tend to demonstrate the highest MMR. Fertility reduction can arrest the deterioration of women’s health. Child survival and fear of losing children influence fertility behaviour—30 per cent of all deaths in children occur before the age of five. Rural women have more children, and they also suffer the greatest losses in terms of death of children.
546. The budgetary allocation for family planning in the First Five-Year Plan (1951–56) was Rs 65 lakh. In the budget for 2000–2001, the budget for family welfare is Rs 3,520 crore (the Department of Family Welfare is demanding a doubling of this figure to implement the new population policy). In short, the expenditure on family planning/welfare has risen at a much faster rate than the growth of population.40


National Population Education Programme

547. The National Population Education Programme has been working to attain the institutionalization of population education in the education system of the country. Population Education Programme in School Stream, which entered Phase IV (1998–2001) in June 1998, is being implemented almost as a new project. It is now known as Population and Development Education in Schools. The overriding objective of the project is the institutionalization of re-conceptualized population education in the content and process of school education. The project is being implemented by National Council for Education Research and Training (NCERT) at the national level and State Councils for Education Research and Training (SCERTs)/State Institutes of Education (SIEs) at the State/UTs levels.41


National Population Policy (NPP)

548. The NPP has sought to address these challenges towards achieving TFR of 2.1 and it lays down specific goals to be achieved by 2010. Those which impact the child include;

Box 6.6: National Population Policy, 2000
The NPP, 2000, the affirms the commitment of the Government towards voluntary and informed choice and consent of citizens while availing of reproductive health care services, and continuation of the target-free approach in administering family planning services. The NPP, 2000, provides a policy framework for advancing goals and prioritising strategies during the next decade, to meet the RCH needs of the people of India, and to achieve net replacement levels (TFR) by 2010. It is based upon the need to simultaneously address issues of child survival, maternal health and contraception, while increasing outreach and coverage of a comprehensive package of RCH health services by the Government, industry and the voluntary non-government sector, working in partnership.

Source: National Population Policy, 2000, GO.I

HIV/AIDS

557. In India, the HIV/AIDS infections are now over a decade old. Within this short period, it has emerged as a serious public health problem in the country. The prevalence of HIV has been reported in all States and UTs.44
558. Prevalence levels of HIV is still low in India at less than one per cent of the adult population. The number of infected individuals, however, is now extremely large, doubling in the last four years to an estimated 3.5 million (1998). Data from sentinel surveillance point to a rapid evolution of the epidemic in the southern and western parts of India. Andhra Pradesh and Karnataka have now overtaken Tamil Nadu to join Maharashtra as States with the highest prevalence of HIV. A distinct but continuing epidemic amongst injecting drug users in Manipur, risks spreading to neighbouring States in the North-East and to major metropolitan centres. The majority of northern States still report very low levels of HIV. Their vulnerability to the epidemic, however, in terms of male migration, adverse gender norms and weak infrastructure makes action in these States critical for the future path of the epidemic.45 It is estimated that around 160,000 children in India are living with HIV/AIDS.46 The predominant mode of transmission of AIDS is through heterosexual contact, followed by blood transfusion, blood products and the use of injectable drugs. The trends indicate that HIV infection is spreading in two ways: from urban areas to rural areas, and from individuals using risky practices to the general population. The data from ante natal clinics indicate a rise in the prevalence of HIV among women, which in turn, contributes to an increase in HIV infection among children.47


Programmes and Strategies

559. Soon after the first case of AIDS was detected in the country in 1986, the National AIDS Committee was constituted under the chairmanship of the Minister of Health and Family Welfare to facilitate effective coordination between various ministries, NGOs and private institutions for implementation the National AIDS Control Programme.48 Realizing the gravity of the epidemiological situation of HIV infection in the country, the GOI launched the National AIDS Control Programme in 1987. The programme focused on increasing awareness of HIV/AIDS, screening blood for HIV and testing individuals practising risky behaviour. The objectives of the first phase of the programme were to prevent HIV transmission, decrease the morbidity and mortality associated with HIV infection, and minimise the socio-economic impact of HIV infection. The project consisted of five components:

  • G034386912.jpg
Table 6.14: Unrounded estimates of the HIV/AIDS epidemic
India
Year
People living with HIV/AIDS
Adults living with HIV/AIDS
Women living with HIV/AIDS
Children living with HIV/AIDS
1997
3,237,060
1,102,994
1,150,83
134,067
1998
3,478,984
3,333,779
1,227,663
145,205
1999
3,704,545
3,548,937
1,298,197
155,609
2000
3,914,355
3,749,060
1,362,961
165,295

Source: UNAIDS-Joint United Nations Programme on HIV/AIDS, Facts and Figures

National AIDS Prevention and Control Policy

567. A comprehensive Draft National AIDS Prevention and Control Policy seeks to prevent the epidemic from spreading further and to reduce its impact not only on the infected persons but on the health and socio-economic status of the general population at all levels. The specific objectives of the policy are:

Counselling

568. People with HIV/AIDS experience a variety of health care and social support needs during the course of their illness. A major drawback is the persistence of stigmatization and discrimination against HIV-infected individuals. This is being countered by PLWAs in some places, who are increasingly becoming open about their illness. It has become necessary for them to face the challenges of this infection and reduce the stress under which they are having to live. As more and more people are getting infected with HIV, the issue of providing care and support, both at the clinical and social level, has become more pertinent. Past experience shows that as soon as the infection is identified, not only the person concerned but also the entire family is subjected to innumerable problems ranging from harassment to total isolation in the community. There have been instances of refusal to admission of AIDS cases in Government hospitals and private nursing homes. There is a need, therefore, to eliminate many a misconception and strengthen health care and social support systems. Care and support, including home-based care and continuum of care has been taken up as an integral component of the National AIDS Prevention and Control Policy. Counselling services to HIV-infected persons are being provided through trained counsellors. Pre-test, post-test and ongoing counselling form the important aspects of counselling. NACO has set up a National AIDS Helpline, which offers counselling services round-the-clock. The telephone is linked to a computerized voice response system, which gives information on various issues related to HIV/AIDS, such as general information, symptoms of HIV infection/AIDS, facilities for testing of HIV, provision of care and support service for those infected and affected by HIV/AIDS. Interested callers can also avail of personal counselling. Such services have been successfully implemented in 35 cities across the country.52


Community care and support centres

669. Community care is an age-old concept practiced for thousands of years under the Indian system of medicine, Ayurveda. In this system, patients are provided care and support in hermitage life settings, therefore, providing an ideal situation for a life free from discrimination and hatred. For providing community care to AIDS patients, a centre has already been opened by the Sisters of the Missionaries of Charity, which is functioning since 1995. Community care centres can be useful in the following ways:

Mother-to-child transmission

570. Under the National AIDS Control Programme, the GOI has initiated a feasibility study for the prevention of mother-to-child transmission by AZT prophylaxis (also know as Zidovudine) in 11 centers in five states with high prevalence of HIV infection. These are Maharashtra, Tamil Nadu, Karnataka, Andhra Pradesh and Manipur. The objective is primarily to assess the feasibility of administering AZT to prevent mother-to-child transmission of HIV infection in pregnant mothers.

571. In the 11 centres, pregnant mothers are imparted education-cum-counselling services in order to make them understand the risk of HIV/AIDS and its implication on the health of the child. They are also informed about the ways and means of preventing transmission, including administration of AZT prophylaxis. All the mothers who accept HIV tests voluntarily are enrolled for the study and tested for HIV infection after informed consent and one-to-one pre-test counselling. Mothers who are found to be positive are counselled about the consequences of HIV infection and the importance of AZT prophylaxis in prevention of infection to the child. Mothers opting for the prophylaxis are provided AZT after 36 weeks of pregnancy54 .

Box 6.7: Strategic focus of each UN agency within the national response
WHO will continue to focus on surveillance, blood safety; clinical care; and STDs (especially on syndromic management), extending this to the continuum of care and ensuring that analysis of epidemiological and behavioural data informs all the agency responses, working closely with NACO and UNICEF on Mother to Child Transmission (MCT).
UNDCP will focus on introducing HIV/AIDS issues into existing national drug demand reduction projects, currently planned to be supported by UNDCP (especially in the north-east of India), establishing linkages between the two programmes and identifying strategic gaps in drug related HIV programmes.
UNIFEM will assist in building capacities of women’s organisations, bringing in gender perspectives to the national HIV policy and programme, and help forge a partnership between Government and women’s organisations in addressing issues of HIV and AIDS.
UNESCO will take lead in reaching young people out-of-school in non-formal education and include HIV in curricula across the spectrum of educational programmes.
UNDP will facilitate empowerment of vulnerable and marginalised populations, making HIV an integral part of its Human Development goals, working with NGOs and partnerships with civil society including PLWAs.
UNFPA will work within its core areas of support, related to HIV in condom programming, reproductive health, and adolescent reproductive health. Specifically drawing on its 38 district level projects in six States, to model and define approaches to integrate HIV/STD control into RCH and the PHC system, and carry out research on population projections on HIV and operational research on the female condom, and microbicides.
UNICEF will take a lead with WHO in demonstrating feasible strategies for MCT; and within its CRC mandate, develop strategies for involvement of youth, especially tackling discrimination; and supporting formative research on areas related to vulnerability of children (street children/orphans, etc.,)
 ILO will initiate actions in promoting the active involvement of its social partners (Employers and Unions) in tackling HIV especially at workplace interventions and protecting rights of HIV positive workers.

Source: India Responds to HIV/AIDS: A strategic response to the HIV epidemic by the GOI, the UN and its Development Partners in India
Information, education and communication strategy for HIV/AIDS

572. Communication continues to be one of the most important strategies in the fight against HIV/AIDS. In the absence of a vaccine or a cure, prevention is the most effective strategy for control. In India, the majority of the population is still uninfected. It, therefore, becomes imperative to continue intensive communication efforts that will not only raise awareness levels but also bring out behaviour change for prevention.


IEC strategy

573. The IEC strategy in NACO is operationalised at two levels. At the national level, political and media advocacy, and the creation of a supportive environment that reduces social stigma and discrimination and provides better access to services have been taken up. At the State level, the IEC activities have been decentralised keeping in mind the need to respond to local priorities and communication in local languages. In order to create baseline data for the AIDS-II Project, NACO has directed the State AIDS Control Societies to conduct a communication needs assessment in every state on the basis of which a state-level IEC plan will be developed.
The objectives of the IEC strategy in the National AIDS Control Programme are:

National level IEC activities 2000-2001
Electronic media

574. NACO is utilising the massive outreach of Doordarshan and private satellite channels for telecast of messages on HIV/AIDS prevention and control during prime-time. These include messages on sexually transmitted diseases, blood safety and voluntary blood donation. Some of the specific activities are as follows:

Print media

575. The IEC department of NACO has prepared several packages of materials aimed at various population groups, to be used by the outreach workers, health workers and peer educators working in government as well as non-government organizations. Some of the important packages are as follows:

National AIDS Telephone Helpline

576. A toll-free National AIDS Telephone Helpline has been set up to provide access to information and counselling on HIV/AIDS-related issues. This is a computerized four-digit number, 1097, with a voice-response system linked with the telephonic hotline. This is a very popular service, since it maintains the confidentiality of the callers and helps the caller clarify doubts and access personal counselling without revealing their identity. The telephone helpline has been extended to 35 cities/towns all over the country.


School AIDS Education Programme

577. Young people are among the most vulnerable to HIV/AIDS. School AIDS Education is one of the important programmes that focuses on students to raise awareness levels, help young people resist peer pressure and develop a safe and responsible lifestyle. The programme reinforces family values and respect for the opposite sex. The activities include training of teachers and peer educators among students, role playing, debates and discussions, question box and access to referral services, if necessary. A training module has been developed for the programme in consultation with UNICEF and Sewadham, an NGO based in Maharashtra, which has successfully implemented the programme.55


Information, Education and Communication (IEC)

578. Information, Education and Communication (IEC) on health activities have been organized on a priority basis in the most vulnerable districts of India. Greater emphasis has been laid on a more judicious media-mix on the basis of local-specific media forms and need-based inter-personal communication schemes. More stress has been laid on grassroots level communication for those audience segments which cannot be reached by the conventional mass media channels. Remote areas have been covered by adopting a multi-media strategy, song and drama programmes and print material designed for semi-literates and neo-literates in a systematic manner. The IEC strategy is now being focused on the socio-economically backward districts as well as the weaker States.
579. As part of the new strategy to utilize the services of eminent film-makers, the ministry has requested them to make feature films on reproductive health issues. Shyam Benegal’s Hari Bhari, a film on reproductive health problems of women in Muslim families has been completed. A radio programme based on folk music, Lok Jhankar (Information for People), is broadcast twice a week from 22 stations of Vividh Bharati (a radio channel) to enlighten the audience in Hindi-speaking areas on RCH and family welfare issues. Hoardings have been installed at prominent places in six big cities of northern India with messages on RCH and family welfare issues. To make local-specific IEC activities more effective, Zilla Saksharata Samitis (District Literacy Committees) are being involved to chalk out area-specific IEC campaigns on vital RCH issues for every district. In this way, family welfare is being integrated with education at the district level and below.56 To orient the community to the principles of RCH, a massive awareness generation campaign has been started under the RCH programme. This campaign elicits the participation of all segments of the society for appropriate child health practices, amongst other things. A notable feature of this programme is the involvement of Panchayati Raj Institutions (PRI). Breastfeeding is being promoted through the Baby-Friendly Hospital Initiative. Projects are being sanctioned to NGOs to promote breastfeeding and to enable hospitals and other health facilities to get certified as “baby friendly”. Communities are also being informed about child health practices through the mass media, including advertisements in papers, panel discussions on TV and radio and through the organization of talks and seminars by experts.58
580. During 1999–2000, six rounds of the Intensified Pulse Polio Immunisation (IPPI) programme were organized—four nationwide rounds, once a month from October 1999 to January 2000, and two more sub-national rounds in eight States—Gujarat, Rajasthan, Madhya Pradesh, Bihar, Uttar Pradesh, Orissa, Assam and West Bengal. It has been recognised that success in generating awareness through a focused IEC campaign was the key to the success of the IPPI programme. A number of audio-visual programmes were produced in Hindi and other regional languages. Video spots were telecast on the national network (Doordarshan). Seven spots on RCH and PPI were completed. In addition, production of spots on family welfare issues and Haseen Lamhe (Beautiful Moments), a 15-minute radio programme, were broadcast in Hindi and 11 regional languages, from 30 stations of the commercial broadcasting services of AIR. The programme covered family welfare, RCH and population issues in an interesting and absorbing manner. The media unit of the Ministry of Information and Broadcasting provided communication support to the family welfare programmes. The focus was on child health problems, population growth, status of women, small family norms and the community needs assessment approach (CNAA). Doordarshan telecast video spots on a range of RCH issues, including polio eradication.


World Bank-assisted Women and Child Development Project

581. A major opportunity for promoting early child development opens up with the recent clearance of the World Bank-assisted Women and Child Development Project. The project covers ICDS service quality improvement in five States—Tamil Nadu, Kerala, Maharashtra, Rajasthan and Uttar Pradesh. It includes a nationwide training component—Udisha, which focuses on improving the quality of training of ICDS child care functionaries and care givers. UNICEF is also a technical and financial collaborator in the project, which seeks to improve the quality and cost-effectiveness of ICDS. Main project benefits would be:

Training

582. The National Institute of Health and Family Welfare (NIHFW) was instituted by the GOI as the nodal agency to coordinate the various training activities under the RCH programme all over the country. Twenty-five two-day workshops were organized in eight States/UTs to sensitize obstetricians, gynecologists, family physicians and medical professionals in the Government on the RCH programme. A project called Improving Access to Quality Reproductive and Child Health Services was implemented through the IMA. Under this, 50 institutions, such as private nursing homes, hospitals and MCH centres, were identified as RCH centres. Each RCH centre would serve a population of one lakh, by providing services like tubectomy, vasectomy IUD insertion, other family planning services and counselling. Twenty-five workshops of two-days’ duration each were organised in different States of the country by the Indian Academy of Paediatrics (IAP). The objective was to orient members of IAP on the concepts of RCH with a view to improving their knowledge and skills related to RCH. Two South East Asian regional training courses in population and reproductive health management were organized by the Indian Institute of Health and Family Welfare, in collaboration with Mahidol University, Bangkok. A collaborative six-week training programme was organized by the Institute of Economic Growth, Delhi and Chulalkorn, Bangkok, for mid-career medical personnel on economics for health analysis.

Box 6.8: Catch ‘em young
A best practice case study on school based AIDS prevention education programmes in Maharashtra, India
Maharashtra, situated on the west coast of India, is the third largest State in the country. It has a total population of 78.9 million, with a literacy rate of 63 per cent. The capital of Maharashtra, Mumbai (previously known as Bombay), is the largest city in India. It has a population of 12.57 million. In Mumbai, the first case of AIDS was detected during May 1996. Since then, Maharashtra has planned and implemented a programme for prevention and control of AIDS.
In India, the question of introducing AIDS education in schools is inextricably linked with the issue of introducing sex education for school children. Education about reproductive health and STD/HIV/AIDS meets with opposition. Parents and the community have to be convinced that such education does not lead to more or earlier sexual activity, as parents generally fear. The rapid spread of STD/HIV/AIDS has intensified the national debate on this issue. Major recommendations have been endorsed, namely, that keeping in view the age of the target group, suitable components of adolescent education should be introduced in the school curricula at all stages. This is based on the conviction that AIDS preventive education can minimise the spread of the AIDS epidemic, because information, values and skills imparted in schools have a long-lasting impact.
Two major strategies are being adopted to integrate AIDS education into the existing school curriculum and the ongoing programme.
Linking AIDS and population education
It is generally agreed that AIDS education cannot be promoted exclusively as a separate independent programme in Indian schools, but should be linked with an existing related programme. The population education programme, which is receiving financial and technical assistance from UNFPA, UNESCO and WHO, has been operational for the last one-and-a-half decades.
The general consensus, as reflected in various documents of UNESCO, WHO and UNFPA and as recommended by NCERT and MHRD is that AIDS-preventive education should be linked with the population education programme, which has infrastructural facilities available both at the State and national levels.
Combining curricula with non-course approach
A non-course approach could be considered supplementary to the main effort to bring about curricula changes. In the ensuing less formal environment, sensitive issues like HIV/AIDS and family life education can be approached more easily in schools.
Maharashtra is the first State in the country to initiate AIDS education on a large-scale in public and private schools. The pioneering efforts of Sevadham Trust, an NGO, Directorate of Health Services (DHS), Mumbai, and Municipal Corporation of Greater Mumbai (MCGM), have institutionalised some of the processes which were initiated for AIDS prevention.
Initially funded by UNICEF, the three pilot projects were subsequently supported with resources by NACO. Each project has been evaluated by external agencies, which have concluded the effectiveness in terms of increased awareness amongst students. It has thus been possible to identify some of the best practice guidelines.

Source: Catch ‘em Young, A Best Practice Case Study on School Based AIDS Prevention Education Programmes in Maharashtra, India, UNESCO publication

583. Two collaborative programmes on population dynamics were organized. The objective was to upgrade the skills of the family welfare personnel and to acquaint the trainees with the population programmes of neighbouring countries. Skill training courses on MTP were conducted in 14 identified institutes. Each institute conducted three courses, and training was given to two or three medical officers in each course. Four training fellowship programmes were conducted on RCH for paramedical personnel working in family welfare. Training courses on population analysis were organized by IIPS for demographers and district family welfare officers. Orientation courses were conducted on RCH and CAN for the faculty of ANM and lady health visitor (LHV) training schools. Eight orientation training courses on RCH programme management were organized for district family welfare officers.58

Box 6.9: National Newborn Week: 15–21 November, 2000
In order to highlight the key importance of newborn health among the current national priorities, the Government organised a Newborn Week throughout the country from 15–21 November, 2000. Activities during the week included seminars, workshops, newborn health melas, newborn care campaigns in underprivileged communities, as well as IEC and media campaigns. The aim was to enhance awareness about newborn health among opinion leaders, professionals, agencies, NGOs and, above all, the public.

Source: Newborn Health—Key to Child Survival (Present Scenario, Current Strategies and Future Directions for Newborn Health in India), Child Health Division, Department of Family Welfare, Ministry of Health and Family Welfare
Involvement of NGOs

584. At the village, panchayat and block levels, small NGOs are being involved in advocating RCH and family welfare practices and general counselling. At the same time, individual NGOs are also being allowed to propose innovative programmes. Small NGOs with limited resources are being assisted through mother NGOs. The Department of Family Welfare intends to establish one mother NGO for every eight to 10 districts. NGOs with substantial resources and proven competence are being approved as mother NGOs. So far, the Department has identified 57 mother NGOs. Mother NGOs are required to provide training to the staff of small NGOs in both management of the NGOs and programme management. Mother NGOs have one nominee from the State Government and one from the GOI in their executive committees.
585. A limited number of major NGOs are being assisted by the Department of Family Welfare on a project basis for innovative programmes. The intention is not to involve the NGOs in duplicating Government programmes, but to take them to areas which are relatively underserved or have special problems. The Department proposes to involve NGOs wherever their involvement is expected to yield good results, e.g. in introducing baby-friendly practices in hospitals, in helping with the enforcement of the Prenatal Diagnostics Technique Act by detecting offending sex-determination clinics, and in collecting evidence for making specific complaints against them to the designated authorities in the State. In addition, some NGOs will be assisted by the hospitals/clinics in urban areas in offering facilities for contraceptive/terminal methods and counselling both in regard to RCH and population control measures.59


International Assistance

586. The RCH programme has an approved outlay of Rs 51,125.3 million under the Ninth Plan. For the year 1999–2000, the programme approved an outlay (budget expenditure) of Rs 6760 million. The details of estimated assistance for the year 1999–2000 are as under.60


Currency Exchange Rate (31 March, 2000) Converson (opp.)

IDA ($) Rs 46.31 Rs 2547 million

ECU Rs 40.49 Rs 809.8 million

DFID (£) Rs 65.78 Rs 1315.6 million

Japan (JY) Rs 37.05 Rs 33678.45 million

KfW (DM) Rs 20.71 Rs 310.65 million

UNICEF (US $) Rs 46.31 Rs 1180.9 million

G034386913.jpg

Source: Annual Report, 1999–2000, Ministry of Health and Family Welfare, GOI
Environment

587. One of the indicators of the quality of life is a clean environment. While the protection and conservation of the environment has been enshrined in the Constitution of India, the level of environmental health both in urban and rural areas in India needs much improvement. This has serious public health implications, and frequent outbreaks of water-borne, vector-borne and air-borne diseases occur.
588. The growing pollution of our rivers constitutes the biggest threat to public health. The assault on India’s rivers—from population growth, agricultural modernization, urbanization and industrialization—is enormous and growing by the day. Rivers support the life of innumerable living species and also human beings. Most Indian cities get a large part of their drinking water from rivers.61 Most Indian rivers and freshwater streams are polluted by industrial wastes and effluents Industrial wastes are toxic to the life forms that consume this water, with potential harm to the liver, kidneys, reproductive system, respiratory system and nervous system.62 Several diseases, like diarrhoea, hepatitis (jaundice), ascariasis (roundworm), hookworm infection, trachoma and dracunculiasis (guinea worm), have been linked to human contact with polluted water. The World Bank and World Health Organization have estimated that 21 per cent of all communicable diseases in India are water related.63 To combat water pollution, the Water (Prevention and Control of Pollution) Act was enacted in 1974. This Act seeks to maintain and restore the wholesomeness of water. The pollution control boards monitor the quality of wastes, discharges and emission from time to time. The Central Pollution Control Board (CPCB) performs the function of a National Board, as well as that of a State board for all States/UTs of India, with a comprehensive programme for the streams and wells in the States.64
589. The speed with which urban air pollution has grown across India in the last decade is alarming. India has 23 cities with over one million people, and ambient air pollution levels exceed WHO health standards in many of them. Air pollution, even in small towns of the country, unpredictably high. The air pollutants include sulphur dioxide, nitrogen oxides and suspended particulate matter. Polluted air has serious effects on health, causing respiratory, cardiac and nervous disorders.65 The Air (Prevention and Control of Pollution) Act was legislated in 1981, providing for prevention, control and abatement of air pollution. In areas notified under this Act, no industrial pollution-causing activity can come up without the permission of the concerned State Pollution Control Board.
590. After the Bhopal disaster, a more comprehensive Environment Protection Act (EPA) was passed in 1986. This is an umbrella legislation, designed to provide a framework for the Central Government to coordinate activities of various Central and State authorities, established under previous laws such as the Water Act and Air Act. This Act provides power to enforcement agencies with necessary punitive powers to restrict any activity that can harm the environment. Environmental health programmes include safe water supply, drinking water quality surveillance, excreta disposal, sanitation, waste-water management, municipal solid waste management, water and air pollution control, chemical and food safety, etc. Community water supply, sanitation and pollution prevention and control continue to be the main thrust of environmental health programmes in India.66
591. The judiciary has strenuously endeavoured over the past two decades to bring in laws in service of the poor and the disadvantaged section of society. The courts have progressively social action litigetion provided legitimacy to the legal mechanism called —a plea undertaken by the public to redress public injury, enforce public duty, protect social right and interests, prevent abuse of power and for indicating public trust.67 Several environmental organizations, academicians, scientists and lawyers have been actively involved in environmental issues in the country. These environmental advocates have made use of the country’s democratic institutions to push for legislative reforms and vigorous judicial enforcement.
592. By raising environmental protection and rights to the Constitutional level, India has provided its citizens with a powerful legal tool to protect wildlife, maintain health standards and curtail degradation of national resources. In India, the Ministry of Environment and Forests is the nodal agency in the administrative structure of the Central Government for the planning, promotion, coordination and of overseeing the implementation of various environmental and forestry programmes.68 The Ministry of Environment and Forests adopted a policy statement in 1992, which inter alia provides several instruments in the form of regulations, legislation, agreement, fiscal incentives and measures to prevent and abate pollution of air, water, noise and land. The Ministry and its associated offices have focussed on preventing and controlling pollution at the beginning of the pipeline by adoption of cleaner technologies, waste minimisation and resource preservation, rather than the traditional treatment at the end of the pipeline. The significant benefit in this approach is that when waste is reduced/eliminated or solvents revived, it leads to resource conservation of the raw materials used during the various industrial processes and minimises the pollutants in the waste water within the premises. Keeping these benefits in mind, the main focus of the pollution prevention and abatement programme has been on command and control methods, as well as voluntary regulations, development of environmental standards, waste minimization circles, environmental audits, environmental epidemiological studies, preparation of a zoning atlas for siting of industries, control of vehicular pollution, promotion of education and awareness campaign, etc. The Ministry of Environment and Forests has constituted a Committee on Environment and Health. The report of the Committee is being finalized. The Ministry has initiated rogrammes/action plans for abatement of pollution:

Box 6.10: Industrial waste water pollution
There are 28 industrial units in Delhi. Most of the small and tiny industries do not have individual facilities to treat liquid waste. The Supreme Court has ordered that 15 common effluent treatment plants (CETPs) be constructed. All water polluting industries in Delhi have been directed to comply with the orders and ensure that they do not discharge untreated effluent. Action has been taken against 2300 industrial units in Delhi so far (January 2000) and continues against all such water polluting units.

Source: Delhi State Report on CRC, Government of NCT Delhi

Lead poisoning

594. In the recent past, a growing concern has been expressed at the potential threat of environmental exposure to lead, particularly in young children and women. Lead exposureof occupational and environmental origin has been found to effect virtually all biochemical processes and organ systems. Lead has been found to interfere with the cardio-vascular system (Schwartz 1992), immune system (Lutz et al, 1999), with blood formation process and with neurological processes. Though lead poisoning is one of the recognized occupational diseases in India since 1924, reliable data on the frequency of non-occupational lead poisoning is not available. The most reliable study in India so far is a nationwide survey of 21,446 children and adults in seven major cities of India. The ZnPP level, was more than 35mg/dl in 28.9 per cent children and 24.1 per cent in adults. Among the subjects with elevated ZnPP levels 46.6 per cent of children and 41.4 per cent of adults had BLL > 10mg/dl. Among estimations done directly without screening by ZnPP more than 50 per cent of the children below 12 years had BLL 10mg/dl. The proportion of children in Delhi, having BLL 10mg/dl was 54.1 per cent, which is very close to the national average of 51.4 per cent (George Foundation Report, 1999). These data clearly emphasize the importance of this problem in Delhi, which seems a fair representative sample of the urban parts of the whole country.

Box 6.11: Industrial air pollution
The air pollution generated from industrial activity in Delhi is about 12 per cent of total air pollution. Although several steps have been taken, industrial pollution needs to be reduced further. More than 1300 industrial units, that were not allowed to operate under the MPD-2001 norms, have been closed. A scheme has been prepared to relocate industrial units that currently operate in residential areas. About 1300 acres of land have been acquired and new industrial estates are being developed at Bawana, Holumbi Kalan and Holumbi Khurd. All industries in Delhi using coal-fired boilers have been asked to switch to oil-or gas fired boilers in order to reduce air pollution generated from industrial activities. All industries are also being advised to control pollution from diesel generating sets. They have been asked to increase the stack height to a level of 2-3 metres above their building height and also take acoustic measures to reduce the noise level from diesel generating sets.

Source: Delhi State Report on CRC, Government of NCT Delhi

595. The major sources of lead poisoning were automobile fuel, food-can soldering, lead-based paint, leaded cooking utensils and drinking water systems. Lead poisoning can lead to permanent brain damage, particularly among young children. Pre-school children are considered to be at high risk because children absorb lead more readily than adults and children’s developing nervous systems are particularly vulnerable to the ill-effects of lead. Additionally, if the source of lead exposure is not removed, persistent toxicity may result in significant and serious impairment of reading skills, deficits in vocabulary, deficits in motor skills, reaction time and hand-eye coordination (Needleman et al, 1999).70
596. The Indian Prime Minister, in a message at an International Conference on Lead Poisoning Prevention and Treatment, in Bangalore in 1999, said that lead poisoning was slowly emerging as a deadly scourge in India and that the Government had taken the first step to eliminate this hazard by making lead-free petrol mandatory for use by automobiles.71


Arsenic poisoning

597. Arsenic is a naturally occurring element, which is widely distributed throughout the earth’s crust. It is introduced into water through the dissolution of minerals and ores, from industrial effluents and from atmospheric depositions. Elevated concentrations of arsenic in groundwater in some areas, is a result of erosion from local rocks. Inorganic arsenic is a documented human carcinogenic. Arsenic contamination of groundwater has emerged as a serious public health threat in a few areas of the country in recent years. So far, 68 blocks in eight districts of West Bengal are affected with this problem, with the population at risk estimated at 1.5 million. A few villages in Rajnandgaon district in Madhya Pradesh have also recently been found to be affected.


Fluorosis73

598. Fluorosis is caused by ingestion of excess fluoride over a long period. It affects multiple tissues, organs and systems of the body, and results in a variety of clinical manifestations, culminating in a crippling condition and/or damaged and discoloured teeth. Fluoride can enter the body through drinking water, food, drugs, dental products and industrial emissions.
599. The problem of excess fluoride in groundwater was detected in many States of India as early as the 1930s. Till 1999, as many as 17 states had been identified with the problem of excess fluoride in groundwater sources.
600. Rajasthan and Andhra Pradesh are the most severely affected States. Rural populations which depend mainly on groundwater for their drinking water supply are the worst affected. Vulnerability to fluorosis is higher if the nutritional status is poor—malnourished children and pregnant or lactating mothers are especially vulnerable. Social and economic implications of flourisis endemicity are enormous, especially for the rural population living below poverty line.
601. Early detection of fluoride toxicity manifestations is crucial for introducing preventive measures. Possible interventions for prevention are:

Initiatives and challenges

602. Government and various official agencies, United Nations organizations, international donor agencies and NGOs have taken the following significant initiatives.


GOI initiatives

603. The Rajiv Gandhi National Drinking Water Mission decided to support the establishment of a water testing laboratory in each district and the implementation of water supply projects in all water-quality affected States, by contributing 75 per cent of the cost, leaving 25 per cent to be borne by the state governments. Seventy major water supply schemes have been implemented, to cover a population of eight million, spread over 4,625 habitations in 10 States under the Submission on Control of Fluorosis.
604. Rajiv Gandhi National Drinking Water Mission is also in the process of establishing a Centre of Excellence for Fluorosis to provide support to all States in their fluorosis mitigation efforts.
605. UNICEF has been working closely with the GOI and other sector partners to assess safety conditions and implement specific fluorosis mitigation programmes. This is part of a comprehensive effort to ensure safe water environments.
606. Some of the key areas of intervention have been in the strengthening of water-quality monitoring systems, facilitating research and development of household water-treatment systems and advocating alternative water supplies when necessary.


Drinking water

607. India has one of the highest coverage figures for rural water supply in the South-Asia Region, which includes Afghanistan, Bangladesh, Bhutan, Maldives, Nepal, Pakistan and Sri Lanka. However, because of its huge population, the absolute number of unserved people in India is so large that it accounts for 60 per cent of the total unserved people in the region.74 According to NFHS-II, 39 per cent of households in India use piped drinking water and the same proportion use drinking water from hand pumps. 19 per cent use drinking water from wells and three per cent from surface water. More than 60 per cent of households use piped water or water from a hand pump for drinking in every State, except Kerala and a few States in the North-East region. In Manipur, Meghalaya and Nagaland, piped water or water from a hand-pump is used for drinking by 41–49 per cent of households, and less than 20 per cent of households use these water sources in Kerala. The majority of households in Kerala obtain drinking water from wells (see table No. 6.15).
608. The National Water Policy (1987) of the GOI, gives priority to drinking water supply. Considerable efforts have been made by the Government towards providing safe drinking water. The Rajiv Gandhi National Drinking Water Mission ensures maximum inflow of scientific and technical inputs into rural water supply and deals with the problems of quality of drinking water and sustainability, whereas the Accelerated Urban Water Supply Programme (AUWSP), launched in 1993–94, targets small towns which face water scarcity.75
609. The Accelerated Rural Water Supply Programme (ARWSP) aims at providing safe and adequate drinking water facilities to the rural population by supplementing the efforts being made by the State Governments/UTs under the Minimum Needs Programme (MNP). Priority is given to habitations not covered and to fully covering partially-covered habitations, which get less than 10 litres of safe drinking water per capita per day. Among them, priority is given to SC/ST areas or those with a larger population of SCs/STs. Priority is also be given to:

Traditional and alternative systems of water supply

611. Neglect of traditional systems prevented revival of the traditional water-harvesting systems or building new systems to complement traditional systems. However, and particularly in the wake of the recent drought, it is now acknowledged that traditional systems to harvest water for domestic purposes continue to have relevance today, particularly in areas where the groundwater is not available or where water quality problems exist. In some areas, traditional systems can provide an essential supplementary source of water, used when piped schemes or borewells run dry during certain times of the year. Traditionally, people in areas of water security used their limited available water judiciously, but now these practices are fading and water conservation education has become a necessity in the country. The revival of traditional systems depends on the ability of water supply programmes to base solutions on the needs and capacities of the users, requiring social rather than technical engineering skills.
12. Indigenous management innovations are not limited to the range of traditional practices, which have been in use for hundreds of years. Local communities have developed many water management innovations relatively recently, in response to newly emerging problems arising from new technologies used in groundwater abstraction. Such local responses include collector wells with multiple horizontal and vertical bores, ponds to store water for use when electric power fails, underground pipes for irrigation and collection of monsoon run-off water in dug wells.78

G034386914.jpg

Sanitation

613. The concept of sanitation was earlier limited to disposal of human excreta by cesspools, open ditches, pit latrines, bucket system, etc. Today, it connotes a comprehensive concept, which includes liquid and solid waste disposal, food hygiene, personal, domestic as well as environmental hygiene. It is well established that there exists a direct relationship between water, sanitation and health inadequacy. The lack of provision of safe drinking water, improper disposal of human excreta and solid and liquid wastes can lead to unfavourable environmental conditions and lack of personal and food hygiene have been the major causes of many killer diseases in many countries, including India. The sanitation coverage in India is one of the lowest in the world.79

G034386915.jpg

614. NFHS–II survey shows that most States in India have inadequate toilet facilities. There are only seven States were more than 70 per cent of households have any type of toilet facility. In order of decreasing proportions, these are Mizoram, Delhi, Manipur, Kerala, Nagaland, Arunachal Pradesh and Sikkim. Less than 30 per cent of households have toilet or latrine facility in Central India and in Orissa, Bihar, Himachal Pradesh, Andhra Pradesh, and Rajasthan (see table No. 6.15).
615. The Ministry of Rural Development is planning a Total Sanitation Campaign (TSC) to suit district-specific requirements. TSC will be implemented in phases. It envisages a synergistic interaction between the Government machinery, active NGO participation and an intensive IEC drive for alternative delivery systems as well as more flexible, demand-oriented construction norms. Fifty-eight pilot districts have been identified by the States for the implementation of phase-I of TSC. In 1997–98, the number of latrines constructed was 1,387,080 and in 1998-99, this number stood at 1,627,363.80 The Ministry of Urban Development is implementing the Low-Cost Sanitation (LCS) Scheme. It provides for the conversion of existing dry-latrines into low-cost water-seal pour-flush latrines, as well as the construction of new sanitary units where none exists, to prevent open defecation. The scheme is operated through subsidies from the Ministry and loans from the Housing and Urban Development Corporation Limited (HUDCO). The total number of schemes sanctioned (April 1999 to 1 January, 2000) were 823. The number of towns covered were 1318.81

616. Among the States, Andhra Pradesh deserves special appreciation for its commendable work in the rural sanitation sector, especially for creating awareness among the rural masses through the Janmabhoomi programme. It is also worth mentioning that Andhra Pradesh has taken a serious note of the vertical upgradation concept. Based on affordability, if a family is not in a position to invest the entire cost, it can start with a single-pit and then switch over to double-pit latrine. Maharashtra constructed a record 461,048 toilets during 1997–98. The State is providing subsidy to all the households under the State-sponsored Gramsafai (village cleanliness) programme.82

Source: India National Family Health Survey (NFHS-2) 1998-99, International Institute of Population Sciences, Mumbai, India

B. Disabled Children

Article 23

Introduction

617. Persons with disabilities are amongst the most marginalized sections of society.1 Children with disabilities face unequal opportunities for survival and development. In many cases, they do not enjoy personal or economic security, and are denied access to health care, education and income-generating activities. Disabled children face difficulties in getting opportunities to participate in sustainable human development programmes and are often victims of deprivation, pain and poverty.2, 3


Current situation

618. There is no systematic, scientific and precise information available on the prevalence, degree and kind of disability, particularly for children. Only a few sample surveys at discrete points of time are available and the information collected through these may not be strictly comparable due to difference in scope, coverage and even concepts. However, the 2001 Indian Census, has collected data on disability throughout the country. Therefore, information on the number of children who are disabled with the particular type of disability will be available from the Census when the tabulation of data is complete. Estimates indicate that about five per cent of the population has some disability or the other. As per the National Sample Survey Organisation (NSSO) survey of 1991, in the field of visual, hearing, speech and locomotor disabilities, it was estimated that about 1.9 per cent of the population of the country was disabled. It was observed that for the country as a whole, the prevalence of physical disability was 20 per thousand persons in rural areas and 16 per thousand persons in urban areas. As regards mental retardation, a sample survey conducted by the NSSO in 1991 for persons with delayed mental development up to the age of 14 years, estimated that about three per cent suffer from delayed mental development. The number of leprosy-affected persons is estimated to be about four million, of whom a fifth are children. Fresh cases of disability every year have been estimated 750,000 as per the 1991 sample survey.
619. Hence, in substance, about five per cent of the population is estimated to be suffering from some kind of disability. There would, of course, be some inter-and intra-State/regional variations. Taking the current population of India to be about one billion, the estimated number of people suffering from a disability is about 50 million. However, only an estimated five per cent of the population with disabilities have been reached by any kind of service. It is also a fact that even the scant services available are highly skewed in favour of the large urban metropolises. The proportion of rural and urban population is 75 per cent and 25 per cent, respectively. The prevalence of disability is thus naturally more in rural areas, where the bulk of the population lives. It has been observed that though a large number of institutions in major cities provide specialised services, there is hardly any network of services available outside cities. Even voluntary effort is largely confined to the urban and semi-urban areas. There is, thus, a wide gap between the demand and supply. Barring minor differences in the magnitude of the services provided by the States, a large section of the people with disabilities are currently not getting services of early detection and intervention, education, vocational training and employment.4
620. According to the India Human Development Report 1999, the incidence of various types of physical disability (such as night blindness, and impairments related to the visual, auditory, vocal and locomotor systems) among the population in the age-group of 0–4 years was 2042 per 100,000 and 2896 per 100,000 children in the age-group of 5–12 years. There is a high prevalence of physical disability among the young as compared to the older age-groups. It suggests that most physical disabilities are genetic, biological and even birth defects. There are wide physical disabilities variations across States. Estimates are low in Kerala and Gujarat among children in the 0–4 years age-group but high in Bihar and West Bengal. In West Bengal, in the age-group of 5–12, the prevalence was as high as 6779 per 100,000, 4670 in Himachal Pradesh and 4519 in Tamil Nadu. This rate was considerably lower in Haryana, the North Eastern States, Gujarat, Karnataka and Kerala. For details see Appendix 6.1.
621. According to the report, there is a somewhat higher incidence of physical disability among the non-land-owning classes, especially wage-earners. Physical disability is much higher among the SCs in the 0–4 years age-group and 5–12 years age-group, that is, 2058 and 3325 disabled children per 100,000, respectively. As far as religion is concerned, the report finds that a relatively high incidence of disability is found among Christians (2711 per 100,000) followed by Muslims (2409 per 100,000) in the 0–4 age-group. However, in the higher age-group of 512 years, the incidence is much higher (3792 per 100,000) among Muslims.5 For details see appendix 6.2.

According to the The Indian Child, a compilation by Child Relief and You (CRY), the figures on disabled children in India are as follows:

Table 6.16: Incidence of disabilities among children (per 100,000)
Region/States
0–4 years
5–12 years
North
Haryana
1322
1396
Himachal Pradesh
2930
4670
Punjab
1557
3565
Upper Central
Bihar
3577
2059
Uttar Pradesh
1771
2004
Lower Central
Madhya Pradesh
1857
3040
Orissa
820
2146
Rajasthan
2092
3711
East
North-eastern Region
2418
1816
West Bengal
325
6779
West
Gujarat
545
1576
Maharashtra
1592
3278
South
Andhra Pradesh
2244
3134
Karnataka
1680
1964
Kerala
494
1697
Tamil Nadu
1088
4519
All India
Person
2042
2896
Gender Disparity
0.87
0.86


The most significant factors causing disability are:

Developments

624. In the last decade and a half, there has been growing awareness about the issues relating to this sector and there were several significant landmarks both at the national and international levels. The year 1981 was declared as the “International Year of Disabled Persons”. In 1982, the United Nations General Assembly adopted the World Programme of Action concerning disabled persons. Principles for the prevention of disability as well as measures for the rehabilitation of people with disabilities and for equalisation of opportunities are outlined therein.
625. India has taken action and made considerable progress in all the categories of action for persons with disabilities. The most important factor has been a shift in emphasis in policies towards disabled persons, from a welfare and charity approach to that of equalization of rights and opportunities.6


Measures

626. Special emphasis has been laid on children with disability in the various national policies. These include the National Policy on Children, 1974, which calls for providing facilities to disabled children, as well as special treatment, education and rehabilitation of children suffering from all types of disabilities; the National Policy on Education, 1986, which stresses integrated education, and the National Health Policy, 1983, which lays emphasis on care and rehabilitation of the disabled.7

Table 6.17: Crude estimates of the size of population suffering from various forms of disability in India
(in million)

0–4 years old
5–12 years old
All children up to 12 years
Bitot's spots
2.3
4.2
6.5
Physical disability
3.6
5.1
8.7
Visual impairment
0.9
2.3
3.2
Hearing impairment
0.3
1.5
1.8
Speech impairment
0.6
0.8
1.4
Locomotor disability
0.4
1.0
1.4
Total
8.1
14.9
23.0


Legislation

627. The Directive Principles of State Policy in the Constitution of India, which are fundamental in governance of the country recognize the obligation of the State to provide “assistance” in the event of sickness and disablement.8
628. One of the steps taken to prevent discrimination against disabled persons was the enactment of the Persons with Disabilities (Equal Opportunities, Protection of Rights and Full Participation) Act (PWD) 1995. This comprehensive legislation treats rehabilitation as a right and aims at the elimination of discrimination and the creation of an inclusive society, which provides opportunities for development of people with disabilities to their fullest potential.
Implementation of Persons with Disabilities (Equal Opportunities, Protection of Rights and Full Participation) Act, 1995
629. In order to effectively implement the provisions of the Act, some of the measures taken by the Ministry of Social Justice and Empowerment are:

Box 6.12: Community action to reach the one-in-ten differently abled child
The Spastic Society of Tamil Nadu (SPASTN) has successfully experimented with a linkage model of community based rehabilitation (CBR) in five blocks of Chengulput district. The activities commence at the prenatal stage through identification of high-risk pregnancies and continue up to the integration of children with disabilities into balwadis and schools. Prevention, AWWs workers’ awareness generation, community sensitisation, early identification (within one week of birth), interventions and home-based training are the major service areas. More than 50,000 children, including 20,000 newborns, have been served by a multi-disciplinary team of rehabilitation professionals.
The most significant aspect of the model is skill-transfer to the local grassroot-level workers in existing Government infrastructure. This is being done in partnership with ICDS and PHCs. In six years, about 1200 ICDS-AWWs and functionaries of PHCs have already been trained in detection and interventions. Services in the area have been fully integrated with local PHCs. In Chengulput district, the district health authorities together with SPASTN have pilot tested and implemented a plan providing training to all concerned health service functionaries. Training is also given to the staff at the first (level) referral units (FRUs) being set up all over the State, as part of the RCH programme.
Innovative ideas like mobile intervention vans and making use of local resources for making assistive devices have also been undertaken. A mobile van is working among the rural areas of Kancheepuram district. Low-cost technology using mud, straw and recycled cardboard are used to develop assistive devices and adapted furniture to help children with disabilities. The focus in Tamil Nadu has been on expansion of the prevention, early detection and community-based intervention approaches to childhood disability through the ICDS and NGO networks and strengthening capacities of communities for early action.

Source: Integrated Child Development Services—booklet, Department of Women and Child Development, Ministry of Human Resource Development, GOI

Integration of disabled children

630. In the process of bringing more disabled children under the umbrella of educational services, integration of education emerged as a cost-effective approach and, therefore, the education system started accepting children with special needs in general schools. The implementation of the integrated education programme addresses the needs of high-risk children who are suspected to be potential dropouts and, therefore, retention of such children has increased. The integration of disabled children has been actually reinforcing better educational practices in the general school system. The centrally sponsored scheme of IEDC is being implemented in various States of the country.11
631. The Rehabilitation Council is a statutory body under the Rehabilitation Council of India Act, 1992, which came into force on 31 May, 1993. The Council is responsible for regulating training policies and programmes for various categories of professionals in the area of disability. Its functions include standardization of training courses at different levels, regularisation of standards of training in training institutions, recognition of institutions/universities for their training courses within and outside the country on a reciprocal basis and maintenance of a Central Rehabilitation Register for professionals possessing recognised qualification in the area of rehabilitation.
632. The Council has registered 10,672 rehabilitation professionals/personnel as on 31 March 1999, in the Central Rehabilitation Register and issued certificates to them. The total number of institutions recognized by the Council for training professionals in the field of rehabilitation of persons with disabilities has gone up to 117.


District Rehabilitation Centre Scheme

633. The District Rehabilitation Centre Scheme (DRC) was initiated by the Ministry of Social Justice and Empowerment. The centres provide services for prevention and early detection, medical intervention and surgical correction, fitment of artificial aids and appliances, therapeutic services such as physiotherapy, occupational and speech therapy, provision of training for acquisition of skills through vocational training, job placement in local industries, etc.
634. Four Regional Rehabilitation Training Centres have also been set up at Chennai, Mumbai, Cuttack and Lucknow for training and manpower development in the field of rehabilitation, particularly for the DRCs.12


National Institutes/Apex Level Institutions

635. The following national institutes/apex level institutions that have been set up in each major area of disability.

Box 6.13: Uniform I-cards for disabled
The Minister of State for Social Justice and Empowerment today reaffirmed the commitment to building a truly integrated nation, where every citizen contributes in equal measure towards the nation’s development. She was speaking at a ceremony organised to confer the National Awards for the Welfare of People with Disabilities on the occasion of Disability Day today.
She announced that uniform identity cards would soon be issued to the disabled across the country, which would help them avail of various facilities. The inclusion of disability as a separate category in Census 2001 is being regarded as a major victory by organisations working for these special people.
The emergent census figures, that would serve as a basis for all national policies, they hope, will put the problems of the disabled in the correct perspective and help them achieve their due rights and privileges.
The National Centre for Promotion of Employment for Disabled People (NCPEDP) launched a six-month campaign ‘Disability and Census 2001’, in September 2000, to generate awareness about the issue, so that maximum disabled are accounted for in the actual head count. Zonal workshops were organised, in which volunteers were trained to convince the disabled all over the country to get themselves enumerated without any inhibitions so that a true picture of the disabled section may emerge at the national level.
According to NCPEDP Executive Director, Javed Abidi, “Till 1941, the census had no mention of the disabled. In 1981, which was the International Year of the Disabled, disability figures were include but the Government had only three categories—totally blind, totally dumb and totally crippled—thereby ruling out those with mental disabilities and deaf. Those with severe disabilities stood at 0.9 per cent.”
Later, the Government dropped disability as a separate bracket in the 1991 Census. “After a long drawn battle, we have managed to get included again for the 2001 Census and want maximum participation by the afflicted, which will be a task to reckon with in the rural areas,” Abidi added.

Source: The Hindustan Times, 4-12-2000.

In recent years, the institutes have started outreach and extension services, which have been of immense benefit to the disabled. They reach out with multi-professional rehabilitation services to slums, tribal belts, foothills, semi-urban and rural areas through community awareness programmes and CBR facilities and services such as diagnostic, fitment and rehabilitation camps and distribution of aids and appliances to the disabled.


Artificial Limbs Manufacturing Corporation of India (ALIMCO)

638. ALIMCO was established in 1972 with the following objectives:

Indian Spinal Injury Centre (ISIC)

640. ISIC has been set up in collaboration with the Italian Government, to provide comprehensive treatment, rehabilitation services and vocational training and guidance to patients with spinal injury. It is the first centre of its kind in Asia. The centre also conducts research in multidimensional aspects of rehabilitation of such patients.

Box 6.14: Disability seminar
The Society for Environmental Awareness, Rehabilitation of Children and Handicapped (SEARCH), a voluntary organisation, organised a national seminar at the Jawaharlal Nehru University (JNU), on ”Rights and Responsibilities of persons with disabilities: Problems and Prospects in the new Millennium." The focal theme of the seminar, which was held on the eve of the World Disability Day, was “Education for the Disabled.”
The seminar began with the release of a souvenir titled From Barrier to Bridges by the Minister of State for Labour and Employment.
SEARCH, an NGO formed by JNU students, has also adopted the villages of Kusumpur and Masoodpur for development in this field.
JNU Vice-Chairman said that much more needs to be done for the physically challenged, along with sensitising the mass. The disabled were equally competent in the delivery of services, he added.

641. A large number of poor and underprivilaged patients with various types of spinal injuries and problems have benefited from the free services offered by ISIC.


Science and Technology Project

642. Science and technology have brought significant changes in society and are playing an equally important role in improving the quality of life of people with disabilities. Through the Science and Technology Project, research and development activity for developing appropriate and innovative technological appliances for the benefit of the disabled is being carried out.
643. The scheme aims to coordinate, fund and direct application of technology in development and utilisation of suitable and cost-effective aids and appliances, and methods of education and skill development, leading to enhancement of opportunities for employment, easier living and mobility, communication, recreation, and integration in society.14

Box 6.15: Development of child's potentialities
Department of Social Welfare has been providing scholarships to the physically handicapped students, provided income of their parents does not exceed Rs.750 per month. Similarly, handicapped persons below 15 years of age, irrespective of their income and profession, are given financial assistance. Also, handicapped persons with prosthetic are provided such aid in the form of artificial appliances, such as tricycles, wheelchairs, crutches, hearing aid, artificial limbs, etc., provided the income of their parents/family does not exceed Rs.500 per month.
In addition to it, special homes have been set up for education and vocational training of handicapped children. In most cases, handicapped children are sent to centres in outside the State on Government expenses.
The Department is providing free boarding and lodging to the destitute/orphans and physically handicapped persons. In this respect, the Department has established 19 Bal Ashrams, 12 Nari Niketan and one blind home, children’s home and observation home so far. About 1500 inmates are enrolled in these institutions.’’

Source: Jammu and Kashmir State Report on CRC, Government of Jammu and Kashmir
Voluntary action

644. The importance of the voluntary sector in the area of rehabilitation of persons with disability can hardly be overemphasized. India has a very large number of NGOs working in various sectors of disability, for a long period of time, with appreciable impact at the micro-level. Many such organisations are being supported by the Ministry of Social Justice and Empowerment under schemes for support to voluntary action. The schemes under which assistance can be given are (a) scheme of assistance to disabled persons for purchase/fitting of aids and appliances; and (b) scheme to promote voluntary action to undertake programme for prevention, detection, intervention, education, and vocational training, employment, counselling manpower development, etc.

Box 6.16: Rehabilitation approaches
Various approaches are being used to provide rehabilitation services to disabled persons. In the conventional approach, services are supply driven, generated and are planned by experts with preconceived ideas.
Institution-based services
In this system, a disabled person comes to the institution and receives training from the professional personnel there. This is the prevailing system in developing countries. This system provides rehabilitation services using high technology inputs for only a small group of disabled persons. Patients coming from far-off places are detached from their community and environment and face problems of transportation. The institution-based delivery system is inappropriate when it comes to providing services to very large numbers of disabled persons. Most disabled people in developing countries come from poor families with little education and are unlikely to take the initiative to avail of these services. Further, the costs and requirements of professional personnel are constraints.
Reach-out institutional based delivery system
In a reach-out system, the professional goes out from the institution to the home of the disabled person and delivers training or other interventions there. If necessary, the disabled person is referred to an institution. This approach is likely to lead to better and more practical results. However, by this system, the profession may be able to treat lesser numbers of disabled them at the institute. Transport poses another problem. So, this type of
service delivery system lacks efficiency. Many Government agencies and NGOs are providing rehabilitation services at the periphery by holding camps in rural areas and providing the disabled with mobility aids. These camps are one-time activities and have very poor follow-up.
Community-based rehabilitation
CBR strategy was developed by WHO after the 1978 Alma Ata Declaration, which stated that comprehensive primary health care should include promotive, preventive, curative and rehabilitative care. The major objective of CBR is to ensure that people with disabilities are able to maximise their physical and mental abilities, have access to regular services and opportunities and achieve full social integration within their communities and their societies. The objective uses the broader concept of rehabilitation, that is, one which includes equalisation of opportunities and community integration. As a broad concept, CBR is recognised as a comprehensive approach which encompasses disability prevention and rehabilitation in PHC activities for gainful economic activities for disabled adults.
As a component of social policy, CBR promotes the right of disabled to live within their communities, to enjoy health and well-being and to fully participate in educational, social, cultural, religious, economic and political activities. CBR, thus, enjoins upon Governments to transfer responsibility and necessary resources to communities so that they can provide the base for rehabilitation.
CBR is implemented through the combined efforts of disabled people, as well as education, vocational and social services. This means that community resources are mobilised to rehabilitate people with disabilities. Community health workers or other community volunteers, who have undergone training in CBR, identify people with disabilities and provide basic information about self-care and mobility, etc., The community health rehabilitation worker and all other activists in the rehabilitation programme, require the assistance of referral services for vocational and social services. It implies that CBR a is multi-sectoral programme and involves several Government departments and its services are to be coordinated at village, block, district, State and Central Level.

Source: Status of Disability in India, 2000, Rehabilitation Council of India, GOI

645. As of 1999–2000, about 95 voluntary organizations have been given grant-in-aid under the scheme of assistance to disabled persons for purchase/fitting of aids and appliances. Approximately, 346 voluntary organisations have been provided grant-in-aid under the scheme for promotion of voluntary action for persons with disabilitiy.15


New initiatives and strategies
National Trust for the Welfare of Persons with Autism, Cerebral Palsy, Mental Retardation and Multiple Disabilities

646. The Government has been increasingly concerned about the need for affirmative action in favour of persons with autism, cerebral palsy, mental retardation and multiple disabilities has enacted the National Trust Act. Action for setting up the Trust has started.
647. The Trust, which will be a statutory body, will primarily seek to uphold the rights, promote the development and safeguard the interests of persons with autism, cerebral palsy, mental retardation and multiple disability and their families. Towards this goal, the National Trust will support programmes which promote independence, facilitate guardianship where necessary, and address the concerns of persons who do not have family support.


National Programme for Rehabilitation of Persons with Disabilities

648. National Programme for Rehabilitation of Persons with Disabilities (NPRPD) was launched to fulfil the obligations enjoined upon the Ministry of Social Justice and Empowerment after the implementation of Persons with Disabilities (Equal Opportunities, Protection of Rights and Full Participation) Act, 1995. The salient features of the scheme include setting up hierarchical service delivery system, starting with the grass-roots level.

Setting up of Regional Composite Centres and Rehabilitation Centres for spinal injuries

649. The present institutional framework, consisting of apex-level institutions dealing with specific areas of disability, is not adequate to provide the requisite support to all regions and States of the country, including the less developed regions and remote areas like the North-East. In these circumstances, a project has been approved recently to set up six regional composite centres, covering all areas of disability in various regions of the country to act as extended arms of the existing national-level institutions. These centres would undertake a package of functions, including manpower development, research and technology inputs as well as model rehabilitation services for catering to persons with disabilities.

650. A scheme has also been taken up to establish four rehabilitation centres for those affected by injuries pinal who require long-term specialized rehabilitation services and management for life.

Over 100 districts to be adopted by national institutes, DRCs and ALIMCO

651. As part of the strategy to take rehabilitation services to the unreached disabled population in the country at their doorsteps, and to maximize outreach in the shortest time, a programme has been taken up under which 100 districts have been identified more than, where composite fitment and rehabilitation centres would be set up in a partnership venture between the national institutes/ALIMCO/DRCs, under the Central Government, and the district administration/State Government. The proposed programme would be cost-effective as the existing resources and facilities, both in the Government and non-governmental sectors, would be used to provide a greater focus on rehabilitation.

National Institute for Multiple Disabilities

652. It has been proposed to set up a National Institute for Multiple Disabilities for providing comprehensive rehabilitation services to people with multiple disabilities under one roof. The institute will provide services like early detection and intervention, psycho-social rehabilitation, etc. It will also undertake manpower development and vocational training programmes. It will conduct a number of short-term and long-term training courses, including orientation courses, and develop material for creating awareness among the community at large.16

APPENDIX – 6.1
Incidence of disability among children in age-group 0-12 years and gender disparity by States
Regions/ States
Bitots Spot
Night Blindness
Visual
Hearing
Speech
Locomotor
Total

0-4
5-12
0-4
5-12
0-4
5-12
0-4
5-12
0-4
5-12
0-4
5-12
0-4
5-12
North
Haryana
492
461
440
85
891
273
170
121
312
297
516
879
1, 322
1, 396
Himachal Pradesh
1, 829
6, 800
551
732
2, 118
2, 674
147
1, 712
1, 088
1, 454
277
809
2, 930
4, 670
Punjab
79
-
109
50
437
539
138
340
727
765
711
2, 022
1, 557
3, 565
Upper Central
Bihar
355
967
477
408
589
595
406
941
2, 192
429
581
539
3, 577
2, 059
Uttar Pradesh
734
1, 055
397
1, 169
915
1, 181
128
190
596
404
335
411
1, 771
2, 044
Lower Central
Madhya Pradesh
2, 456
3, 510
1, 709
2, 570
984
1, 626
190
303
303
434
562
921
1, 857
3, 040
Orissa
267
627
589
1351
257
599
270
859
350
520
114
468
820
2, 146
Rajasthan
2, 248
7,579
1, 103
4, 206
1, 217
1, 918
56
281
175
866
820
1, 034
2, 092
3, 711
East
North-east
883
874
927
786
1, 725
1, 165
353
409
546
280
465
140
2, 418
1, 816
West Bengal
1, 222
2, 678
108
2, 299
393
2, 015
1, 128
3, 474
1, 163
1, 219
730
1, 075
325
6, 779
West
Gujarat
1, 509
1, 920
236
100
332
682
-
100
80
250
132
544
545
1, 576
Maharashtra
1, 722
2, 648
310
1, 262
817
1, 397
270
742
325
966
478
605
1, 592
3, 278
South
Andhra Pradesh
1, 790
992
24
551
1, 081
1, 032
95
821
408
727
1, 074
1, 122
2, 244
3, 134
Karnataka
703
1, 037
698
642
761
590
666
629
824
1, 040
517
570
1, 680
1, 964
Kerala
34
-
34
200
-
467
34
567
423
701
105
757
494
1, 697
Tamil Nadu
1, 455
5, 297
179
890
89
1, 481
64
672
503
1, 808
831
1, 839
1, 088
4, 519
All India
Person
1, 136
2, 090
532
1, 273
782
1, 160
279
763
735
678
536
751
2, 042
2, 896
Gender disparity
0.91
0.95
1.01
1.07
0.92
1.09
1.05
0.87
0.74
0.74
0.74
0.73
0.87
0.86

APPENDIX – 6.2
Incidence of disabilities among children in age-group 0-12 years and gender disparity by population groups
Population Groups
Bitots Spot
Night Blindness
Visual
Hearing
Speech
Locomotor
Total

0-4
5-12
0-4
5-12
0-4
5-12
0-4
5-12
0-4
5-12
0-4
5-12
0-4
5-12
Household income groups
Upto 20,000
1,129
2,460
550
1,523
665
1,289
298
922
673
734
538
839
1,946
3,21
20,001–40,000
1,223
1,992
469
1,140
868
1,182
274
639
945
563
525
669
2,332
2,688
40,001–62,000
1,290
1,363
717
729
1,092
832
255
530
355
268
732
544
2,021
1,974
62,001–86,000
1,043
793
419
851
717
1,060
203
496
967
1,807
440
1,021
1,598
3,955
Above 86,000
430
725
394
502
978
162
206
295
829
615
220
382
1,841
1,293
Poverty line groups
Lower segment below
1,280
3,038
626
1,774
760
1,199
282
859
479
653
521
690
1,836
2,861
Upper segment below
1,160
2,302
477
1,281
681
1,403
348
1,010
815
731
665
945
2,258
3,521
Lower segment above
1,187
1,907
435
1,170
717
1,093
244
660
887
728
499
720
2,045
2,823
Upper segment above
751
860
751
801
1,151
916
264
531
566
493
461
632
2,000
2,195
Landholding groups
Landless wage earner
1,252
2,439
488
1,013
627
1,187
136
1,030
935
1,064
646
1,014
2,014
3,530
Marginal
805
2,121
476
1,486
621
1,203
374
978
434
655
388
553
1,636
2,875
Small
1,450
2,126
731
1,510
1,058
1,174
259
630
1,032
393
508
609
2,559
2,518
Medium
1,303
1,886
482
1,187
679
1,070
167
469
774
509
513
655
2,089
2,312
Large
1,254
1,436
488
841
693
1,000
113
172
628
1,057
356
832
1,364
2,845
Landless others
1,139
1,994
512
1,083
1,057
1,149
298
637
777
596
821
1,046
2,522
3,080
Landowners
1,104
2,022
549
1,387
758
1,156
312
724
671
596
437
611
1,933
2,686
Landless
1,199
2,225
500
1,046
830
1,168
212
841
860
839
729
1,029
2,253
3,314
Occupational Groups
Cultivators
1,121
2,170
544
1,348
686
1,143
296
686
806
570
455
689
1,996
2,735
Salaried+Prof.+S. Empl
968
1,658
307
621
913
733
188
537
339
515
352
791
1,509
2,196
Wage earners
1,219
2,382
575
1,295
599
1,114
263
1,049
698
996
553
908
1,850
3,301
All others
1,181
1,779
611
1,547
1,212
1,611
328
727
914
626
863
657
2,866
3,285
Social Groups
Caste














STs
2,153
2,277
1,028
1,668
890
1,063
158
576
725
413
307
746
1,881
2,406
SCs
1,084
2,757
552
1,497
638
1,088
285
1,272
843
693
564
803
2,058
3,325
Religion
Hindu
1,195
2,112
566
1,283
796
1, 119
264
689
717
663
508
737
1, 983
2, 771
Muslims
1,067
2,312
167
1,409
571
1, 435
324
1, 328
944
823
781
830
2, 409
3, 792
Christians
108
944
2,064
647
2064
1, 612
294
590
52
559
351
298
2, 711
2, 200
Other Minorities
307
1,111
154
700
492
972
501
764
785
573
451
1, 153
1, 831
3, 386
Household Size Groups
Up to 4
969
1,996
571
1,181
993
1, 381
233
965
417
825
649
1, 053
2, 005
3, 410
5–7
1,138
2,155
547
1,312
729
1, 171
274
911
936
726
468
755
2, 125
3, 070
8 and above
1,200
2,015
499
1,239
764
1, 069
303
456
615
550
574
646
1, 953
2, 444
Adult Literacy Groups
None Literate
1,158
2,376
591
1,317
694
1, 041
219
883
499
784
525
876
1, 844
3, 036
Female Literate
772
2,029
860
2,108
1, 165
1, 447
329
1, 596
267
720
280
357
1, 547
3, 049
Male Literate
1,235
2,239
485
1,315
846
1, 166
309
618
826
661
463
876
2, 125
2, 831
Both Literate
1,051
1,671
506
1,116
775
1, 240
298
735
878
593
627
535
2, 160
2, 823
Village Development Groups
Low
1,179
2,207
621
1,451
783
1, 111
287
510
856
633
515
672
2, 199
2, 541
Medium
1,200
2,008
483
1,214
811
1, 188
224
788
682
625
574
765
2, 129
2, 877
High
991
2,071
496
1,146
738
1, 177
348
1, 030
665
808
505
826
1, 720
3, 349
All India














Person
1,136
2,090
532
1,273
782
1, 160
279
763
735
678
536
751
2, 042
2, 89
Gender disparity
0.91
0.95
1.01
1.07
0.92
1.09
1.05
0.87
0.74
0.74
0.74
0.73
0.87
0.86

C. Social Security and Childcare Services and Facilities

Article 26 and 18, para. 3

Introduction

653. Social security refers to the protection which the society provides to its members through a series of public measures against economic and social hardships caused by stoppage or substantial reduction of earnings, resulting from sickness, maternity, employment injury, unemployment, invalidity, old-age and death subsidise. It includes medical care for families with children.1 In India, although social security for children is not a separate entity, the GOI has been concerned about providing childcare services and facilities so as to prevent child abuse and neglect.2


Constitutional provisions

654. The Indian Constitution emphasizes social security in its Directive Principles of State Policy. These provisions reflect those in the CRC. The Directive Principles aim towards the ideals of building a true welfare state and inter alia envisage an end to economic exploitation, inequalities and inequities, and cast upon the State the duty to secure a just social order. Thus, article 38, which is the key of the Directive Principles, lays down that “The State shall strive to promote the welfare of the people by securing and protecting as effectively as it may a social order in which justice, social, economic and political, shall inform all the institutions of national life.” Article 39 says, “the State shall direct its policy in such a manner as to secure that all men and women have the right to adequate means of livelihood, that the ownership and control of the material resources of the community are so distributed as best to subserve the common good; that the economic system is not allowed to result in the concentration of wealth and means of production to the detriment of the common good, that there is equal pay for equal work for both men and women, and that the health and strength of workers, men and women, and the tender age of children are not abused, that citizens are not forced by economic necessity to enter a vocation unsuited to their age or strength, and that childhood and youth are protected against exploitation”. Some of the other important Directives relate to the provision of free and compulsory education for all children up to the age of 14 (art. 45); promotion of educational and other weaker sections (art. 46); duty of the State to raise the level of nutrition and the standard of living and to improve public health (art. 47). Even though made non-justiciable, the Directive Principles have thus far guided the Parliament and State Legislatures in enacting social reform legislation; the courts have cited them in support of their interpretation of constitutional provisions and the Planning Commission has accepted them as useful guidelines for determining approach to national reconstruction and rejuvenation.3


Policy and legislation

655. The National Agenda for Governance enunciated the government’s intention to announce the National Charter for Children with the aim to ensure that no child remains illiterate, hungry or lacks medical facilities. An approach paper on the National Charter for Children has also been prepared and circulated to all States/UTs for suggestions.
656. In India, social security programmes are designed to provide benefits, both in cash and kind upon the occurrence of certain contingencies. Under the Constitution of India, social security in its broad sense is envisaged in terms of the Directive Principles of State Policy. Though India has not ratified all the ILO conventions relating to social security, there are national laws which provide for mandatory benefits in respect of certain provisions, such as employment generation. These include medical care and sickness benefits, invalidity and survivor benefits, employment injury benefits and maternity benefits. There are also laws enacted and schemes established by the Centre/State Governments providing for social security and welfare of specific categories of working people.
657. Box 6.17 summarizes various social security laws applicable in India. Most of the laws are applicable to workers belonging to the organized sector. At the same time, the benefits reach the children of workers indirectly. The Beedi and Cigar Workers (Conditions of Employment) Act, 1966, the Plantation Labour Act, 1951, the Contract Labour (Regulation and Abolition) Act, 1970, the Inter-State Migrant Workmen (Regulation of Employment and Condition of Service) Act, 1979, The Factories Act, 1948 and the Building and Other Construction Workers (Regulation of Employment and Conditions of Service) Act, 1996, lays down provision for establishment of crèches for the benefit of women workers.4 Further the Maternity Benefit Act, 1961 and the Building and Other Construction Workers (Regulation of Employment and Conditions of Service) Act, 1996 provides maternity benefit to the female workers.5 The GOI provides “3 months maternity and 15 days paternity” leave to its employees. Further, the maternity leave can be extended to one year without loss of pay.
658. Some of the developments and improvements which have been made in social security with respect to children during 1999-2000 are as follows:

Box 6.17: Principal social security laws of India
Act Objective
The Workmen’s Compensation To provide compensation in cases of industrial
Act, 1923 accidents/occupational diseases resulting in disablement or death
Employees’ State Insurance To provide for health care and cash benefits
Act, 1948 in case of sickness, maternity and employment injury.
Employees Provident Funds To provide:
and Miscellaneous Provisions Compulsory Provident Fund
Act, 1952 Pension
Deposit Linked Insurance
Maternity Benefit Act, 1961 To provide for maternity protection before and after child birth.
Payment of Gratuity Act, 1972 To provide for payment of gratuity on ceasing to office
.

Source: Annual Report, 1999-2000, Ministry of Labour, GOI

Central Government interventions

659. In India, the concept of social security is an integral part of various programmes undertaken by the GOI. Some of the programmes/schemes, which provide social security, are mentioned below:


Public Distribution System

660. One of the main constituents of the Government’s strategy for poverty alleviation is the public distribution system (PDS). Through the PDS, food security is enhanced, particularly for the economically weaker sections of society. PDS ensures the availability of essential commodities like wheat, rice, sugar, edible oils and kerosene through a network of outlets or fair price shops (FPS). There is, at present, a network of about 460,000 PDS retail outlets in the country. Efforts to streamline the PDS have resulted in the targeted public distribution system (TPDS), which was adopted in June 1997. This system follows a two-tier subsidized pricing structure: for families below the poverty line (BPL) and for those above the poverty line (APL), the former representing the poorest of the poor. Under TPDS, the Government issues 25 kgs of foodgrains per month per BPL family at a price equal to half of the economic cost. In practice however, the current issue-price to BPL families is much less than half of the economic cost. The quantity of foodgrains earmarked to meet BPL requirements is 72 lakh tonnes per annum, benefiting an estimated 60 million people.7


Integrated Child Development Services (ICDS)

661. The Integrated Child Development Services (ICDS) programme is globally recognised as one of the world’s largest and most unique community-based outreach systems for promoting early childhood care for survival, growth and development. The ICDS scheme provides supplementary food to needy children and to expectant and nursing mothers from low-income families for 300 days a year. The programme has been dealt with in detail under the section on General Principles.


National Programme for Nutritional Support to Primary Education

662. The National Programme for Nutritional Support to Primary Education (NP-NSPE), popularly known as midday meal scheme, was launched in 1995. The programme is designed to give a boost to the universalisation of primary education by impacting enrolment, attendance, retention and the nutritional needs of children in primary classes.8


Sarva Shiksha Abhiyan (SSA)

663. The Ministry of Human Resource Development has launched a new scheme called the ‘Sarva Shiksha Abhiyan’ (Education for All) to incorporate all the existing schemes and programmes in the elementary education sector. The objective of SSA is to provide quality elementary education to all children in the age-group of 6-14 years by 2010. There will be a special focus on girls, children belonging to SC/ST communities, urban slum-dwellers and low female literacy blocks.9


Antyodaya Anna Yojana

664. The Antyodaya Anna Yojana was launched by the Prime Minister of India in December 2000. This scheme reflects the commitment of the GOI to ensure food security for all, create a hunger-free India in the next five years and to reform and improve the public distribution system so as to serve the poorest of the poor. The scheme contemplates identification of 10 million families from the total number of BPL families who would be provided food grains at the rate of 25 kg per month. The food grains will be issued by the GOI at Rs 2 per kg for wheat and Rs 3 per kg for rice.


Crèches/day-centres for children of working/ailing mothers

665. The Central sector scheme of running crèches/day-care centres for children of working/ailing mothers aims to provide day-care services mainly for children (0-5 years) of casual, migrant, agricultural and construction labourers. Children of mothers who are sick or incapacitated due to sickness or suffering from communicable diseases are also covered.


Balwadi Nutrition Programme (BNP)

666. The Balwadi (home for children) Nutrition Programme (BNP) is being implemented through the Central Social Welfare Board and four national-level voluntary organizations. The BNP aspires to meet the very basic nutritional requirements of children in the age group 3-5 years by ensuring provision of 300 calories and 12-15 gm of protein every day. This scheme is being implemented only in the areas not covered by the ICDS.


Early Childhood Education (ECE)

667. The ECE scheme is being implemented as a strategy to reduce dropout rates and to improve the rate of retention of children in schools. The scheme is run by voluntary organizations through 4365 centres in nine educationally backward States of Andhra Pradesh, Assam, Bihar, Jammu and Kashmir, Madhya Pradesh, Orissa, Rajasthan, Uttar Pradesh and West Bengal.10


Balika Samriddhi Yojana (BSY)

668. BSY covers up to two girl children born on or after 15 April 1997 in a family living below the poverty line as defined by the GOI, in any rural or urban area. Under the scheme, the girl child is entitled to receive scholarships for each class of study successfully completed by her. The scholarship amount is deposited in an interest-bearing account in a bank or post-office in the name of the girl child. The interest on the deposit can be utilized for purchase of textbooks or uniforms for the girl child.11


Educational concessions to children of armed forces personnel killed/disabled during hostilities

669. The GOI and most States and Union Territories offer educational concessions by way of reimbursement of tuition fees, boarding-lodging expenses, expenditure incurred on uniforms, textbooks, transport charges, etc., to school students who are the wards of armed forces personnel killed or permanently disabled in the course of thier duties.12


Central sector scheme of special educational development programme for scheduled castes girls very low literacy level

670. The scheme provides a package of educational inputs through residential schools for SC girls in areas of very low SC female literacy where traditions and environment are not condusive to their learning.13


Centrally sponsored scheme of Pre-metric (Class 10) Scholarship to children of those engaged in unclean occupations

671. The scheme financially assists the children of scavengers and sweepers having traditional link with scavenging, flayers and tanners, irrespective of their religion, to pursue education up to the matriculation level. There is no income ceiling prescribed under the scheme.14


Centrally Sponsored Scheme of Girls and Boys Hostels for Scheduled Castes

672. The main objective of the scheme of hostels for SC boys and girls is to provide hostel facilities to SC students studying in middle schools, higher secondary schools, colleges, and universities.15


Central sector scheme of upgradation of merit of SC/ST students

673. The objective of the scheme is to upgrade the merit of SC/ST students by providing them with facilities for all-round development through education in residential schools.16


An Integrated Programme for Street Children

674. The programme provides for shelter, nutrition, health care, education, and recreation facilities to street children and seeks to protect them against abuse and exploitation.


National Family Benefit Scheme

675. Central assistance is available for a lump-sum family benefit for households below the poverty line on the death of primary breadwinner in the bereaved family subject to the conditions laid down in the scheme.


National Maternity Benefit Scheme

676. The scheme being implemented by the Ministry of Rural Development provides a lump-sum cash assistance to women of households below the poverty line, subject to conditions laid down in the scheme.


National Child Labour Policy (NCLP)

677. A major activity undertaken under the NCLP is the establishment of special schools to provide non-formal education, vocational training, supplementary nutrition, stipend, health care, etc., to children withdrawn from employment.17
678. To extend some social security cover to the poorest sections of society, the Finance Minister in his budget speech 2000-20001, announced the introduction of a new scheme for group insurance, the Janashree Bima Yojana. Under this scheme, beneficiaries will have an insurance cover of Rs 20, 000 in case of natural death, Rs 50,000 in case of accidental death or total permanent disability and Rs 25,000 for partial permanent disability due to an accident. Below poverty line participants will pay only half the premium, the remainder being contributed from earnings of LIC’s existing social security fund.


Challenges

679. Developed social security and welfare measures exist only in very limited areas such as maternity leave and terminal benefits in employment. Deregulation and non-intervention by the State can expose low-income children to greater risks and undermine the potential of the Government to fulfil its role under the Convention.18 Moreover, one of the major difficulties encountered in the implementation of social security is that it is limited to the organized sector. Also, India being a vast country, it is difficult to reach children in remote parts of the country.

D. Standard of Living
Article 27

Introduction

680. Children represent the most valuable asset of any nation. The Central and State Governments of India have taken a number of initiatives to ensure that the rights of every child are protected through various social welfare measures that seek to improve their standard of living and fulfil their unique needs.
681. The Indian President’s address to the Parliament on October 25,1999 spelt out the government’s strategy and policy approach to employment generation and social development. This policy envisages rapid and multi sectoral growth through a bold strategy of economic reforms. The Government is expected to provide strong policy and regulatory leadership; the private sector will provide the dynamism and efficiency of the competitive environment; and local democratic institutions and the civil society will bring about enthusiastic participation by the people.
682. Elements of the social policy include:

Current situation

690. In rural India, the poverty line is estimated to be Rs 2,444 per year. On the basis of the poverty line measure, the head count ratio (HCR) for rural poor in India was estimated to be 39 per cent in 1994. The highest percentage of poor are found in Orissa (55 per cent), followed by West Bengal (51 per cent), Himachal Pradesh (45 per cent), Bihar (42 per cent), and Uttar Pradesh, Madhya Pradesh and Rajasthan (40 per cent each). A lower proportion of poverty is found in Andhra Pradesh, Haryana, Kerala, Punjab, Karnataka, Tamil Nadu and Maharashtra.

691. Both the incidence and intensity of poverty are higher among Scheduled Tribes and Scheduled Castes in comparison with the national average. The HCR is about 50 among STs and SCs in comparison with only 39 for rural India. The HCR is 43 per cent among Muslims, in comparison with only 27 among Christians and 39 among Hindus.6

692. According to the Economic Survey 1999-2000, the incidence of poverty expressed as the percentage of people below the poverty line is observed to have declined from 56.4 per cent in 1973-74 to 37.3 in 1993-94 in rural areas and from 49 per cent to 32.4 per cent in urban areas. For the country as a whole, the percentage of people below the poverty line declined from 54.9 per cent in 1973-74 to 36 per cent in 1993-94. However, the number of poor in the country remained more or less stable at around 320 million due to the rise in population.

693. The National Council of Applied Economic Research (NCAER) survey in rural India in 1994 estimated the total expenditure per capita per month at current prices. These expenditures give an indication of the level of expenditures and the type of expenditures in rural India. The mean per capita per month household expenditure worked out to be Rs 287. This expenditure ranged from a high of Rs 554 in Punjab, to a low of Rs 208 in Madhya Pradesh and Rs 210 in Orissa.

694. Expenditure on foodgrains alone was estimated to be about 31 per cent, but this proportion was low in Haryana, Punjab and Rajasthan. On the other hand, expenditure on foodgrains was found as high as 43.3 per cent and 42.7 per cent in Bihar and Orissa, the poorer states. Expenditures on health and education are 7.4 per cent and 3.1 per cent, respectively for rural India. Per capita proportion of expenditure on health care is high in Uttar Pradesh, Tamil Nadu, Madhya Pradesh and Andhra Pradesh. Lower expenditures are found in Gujarat, Orissa, Haryana and Punjab. Expenditure on education of children is high in Himachal Pradesh, followed by Kerala and Haryana. It is low in Andhra Pradesh, Rajasthan, Uttar Pradesh and Tamil Nadu.
695. The per capita consumption of food grains varies only marginally according to various population groups. Consumption levels are lower for landless labourers, those living below the poverty line, and those living in larger households. The lower levels of consumption among all these groups appear to be due to lack of purchasing capacity or resources. The consumption of cereals is low among Scheduled Tribes, which may be due to geographic and cultural reasons. Since Scheduled Tribes live in remote areas, and possibly hilly and forest areas, their access to food grains is likely to be limited, and may be supplemented by other food items available from common property resources.7

696. Kerala has emerged as a leader in terms of the human development index based on life expectancy, adult literacy and GDP. The State is one of the few areas in the developing world where the birth rate fell to a very low level—25 per thousand—in the 1980s and less than 20 in the 1990s. Along with the decline in fertility came improvements in health, hygiene, sanitation, literacy and status of women. Its success is due to a higher level of investment in the sectors of social development, particularly in the fields of health and education.8

Table 6.18: Rising per capita health expenditure in Kerala
Year
Per capita health expenditure
1993
94 Rs 98.53
1997
98 Rs 168.22
1998
99 Rs 192.56
1999
2000 Rs 233.54

Source: Kerala State Report on CRC, Government of Kerala

Quality of life

697. In India, electricity, source of water, availability of safe drinking water, sanitation facility, the type of housing, cooking fuel and per capita income are some of the indicators used to assess the standard of living.

698. NFHS-2 estimates that the proportion of households with electricity is 91 per cent in urban areas and 48 per cent in rural areas. Thirty-nine per cent of households in India use piped drinking water, the same proportion drink water from hand-pumps, nineteen per cent drink water from wells and 3 per cent drink surface water. Only 24 per cent of households have a flush toilet that uses piped water or bucket for flushing, Twelve per cent have a pit toilet or latrine, and 64 per cent have no facility. Again, there are large urban-rural differences; 64 per cent of urban households have flush toilets compared with only 9 per cent of rural households.

699. Several types of fuel are used for cooking in India, with wood as the most common type. Overall, 59 per cent of households rely mainly on wood, 17 per cent on liquid petroleum gas, 13 per cent on either crop residues or dung cakes, 8 per cent on kerosene, and the rest on other fuels. Sixty-eight per cent of urban households rely mainly on liquid petroleum gas or kerosene, while 73 per cent of rural households rely mainly on wood.
702. Table 6.19 presents an inter-state comparison of housing characteristics. The percentage of households with electricity is lowest in Bihar (18 per cent), Assam (26 per cent), Orissa (34 per cent), and West Bengal and Uttar Pradesh (37 per cent each). More than 90 per cent of households have electricity in Delhi (98 per cent) Himachal Pradesh (97 per cent). In addition, over three-quarters of households have electricity in Haryana, Gujarat, Mizoram, Sikkim, Tamil Nadu and Manipur.

Table 6.19: Some quality of life indicators
Selected housing characteristics by State, India, 1998-99
State
With electricity
With drinking water that is piped or from a hand pump
Percentage of households
Living in a pucca house
Mean number of persons per room
With a toilet or latrine facility
Using biomass fuel for cooking
India
60.1
77.9
35.9
71.7
32.0
2.7
North






Elhi
97.7
98.7
94.4
3.6
88.2
2.2
Haryana
89.1
88.0
39.0
66.9
46.7
2.4
Himachal Pradesh
97.2
77.4
26.7
64.0
28.7
1.8
Jammu& Kashmir
90.1
70.6
51.0
65.8
36.1
2.2
Punjab
95.5
98.9
51.4
60.6
52.1
2.1
Rajasthan
64.4
69.8
27.8
81.0
41.4
3.0
Central






Madhya Pradesh
68.1
63.5
22.2
79.3
19.2
2.9
Uttar Pradesh
36.6
85.6
26.5
82.8
24.8
3.1
East






Bihar
18.2
75.4
16.8
85.9
15.5
2.9
Orissa
33.8
65.3
13.5
86.8
14.8
2.4
West Bengal
36.7
89.3
44.8
65.7
32.8
2.7
North-East






Arunachal Pradesh
68.9
80.7
73.0
80.8
14.2
2.2
Assam
26.4
60.1
63.0
87.1
10.9
2.1
Manipur
75.3
48.9
92.0
69.2
7.1
2.1
Meghalaya
41.2
42.1
52.0
83.5
14.5
2.0
Mizoram
84.1
63.2
97.7
57.4
16.2
2.6
Nagaland
56.3
40.5
74.3
86.1
18.1
1.6
Sikkim
80.7
84.6
72.7
63.2
50.6
2.0
West






Goa
93.5
61.8
58.9
41.4
51.0
1.6
Gujarat
84.3
84.5
44.9
54.5
45.2
2.7
Maharashtra
82.1
81.9
45.9
51.9
28.3
3.0
South






Andhra Pradesh
74.4
78.5
27.3
74.1
39.9
2.9
Karnataka
80.9
87.0
38.6
67.8
41.2
2.5
Kerala
71.8
19.9
85.2
81.7
79.8
1.3
Tamil Nadu
78.8
85.0
34.0
66.5
27.6
2.2

Source: India, National Family Health Service (NFHS-2), 1998-99, International Institute for Population Sciences, Mumbai, India

703. The issue of drinking water and sanitation has been discussed in detail under the article on Health and Health Services.

704. The percentage of households living in pucca houses is quite low in most States. In Orissa, Bihar, Madhya Pradesh, and all States in the North-East except Sikkim, less than 20 per cent of households live in pucca houses. Delhi (88 per cent) and Kerala (80 per cent) are the only States in which more than 60 per cent of households live in houses classified as pucca. Households are least crowded in Kerala (1.3 persons per room), followed by Goa and Nagaland (1.6 persons per room). Households in Uttar Pradesh, Rajasthan, Maharashtra, Andhra Pradesh, Bihar, and Madhya Pradesh have an average of around three persons per room, which puts them in the most crowded category.

705. Overall, half of the households in India do not own any agricultural land. Thirty-nine per cent of households in rural areas do not own agricultural land, compared with 80 per cent of households in urban areas. In rural areas, among those who own land, 64 per cent have at least some irrigated land. The proportion of households owning a house is 78 per cent in urban areas, 95 per cent in rural areas, and 90 per cent overall. The proportion of households owning livestock is 14 per cent in urban areas, and 47 per cent overall.

706. The possession of durable goods is another indicator of a household’s socio-economic level. The majority of Indian households have a cot or a bed (81 per cent) or a clock or watch (67 per cent). Other durable goods found in many households are bicycles (48 per cent), mattresses (47 per cent), chairs or electric fans (46 per cent each) tables (40 per cent), radios (38 per cent), pressure cookers (30 per cent), and black and white televisions (25 per cent). A small proportion of households own sewing machines (18 per cent), motorcycles, scooters, or mopeds (11 per cent), refrigerators (11 per cent), colour televisions (10 per cent), water pumps (9 per cent), telephones (7 per cent), and cars (2 per cent). Urban households are much more likely than rural households to own each of these durable goods. In rural areas, 9 per cent of households own a bullock cart, 3 per cent own a thresher, and 2 per cent own a tractor.9

Purchasing Power Parity (PPP)

707. Purchasing power parity is an adjustment which is applied to incomes and is useful for comparing the living standards in different countries. The PPP is the adjustment for research purposes of data on the money incomes to reflect the actual power of a unit of local currency to buy goods and services in its country of issue, which may be more or less than what a unit of the same currency will buy of equivalent goods and services in foreign countries at current market exchange rates.

708. According to the UNDP Human Development Report 2000, the GDP per capita income of India in US dollars as per the PPP was US$ 2,077 in 1998.

Table 6.20: Comparison of GDP per capita (PPP US$) - 1998
Country
GDP per capita
China
3105
Indonesia
2651
India
2077
Pakistan
1715
Bangladesh
1361

709. This compares favourably with other high population developing countries.
710. The PPP percapita income in India compares favourably with India’s per capita income, which was US$ 444 in 1998 (HDR 2000).
711. The GDP per capita of India has doubled over the past 25 years, according to HDR 2000. The increase has been proportionally higher in the recent decade.

Table 6.21: GDP per capita (1995 US$)
1975
222
1980
231
1985
270
1990
331
1998
444


Disparities

712. There is a considerable male-female disparity in GDP per capita income. The PPP-adjusted GDP per capita is US$ 1,105 for females and US$ 2,987 for males. The income of females is only about 40 per cent that of males.
713. There are large variations in the per capita income of India’s States and UTs as shown in Table 6.22.
714. There is a strong correlation between income and many development indicators, as revealed in a survey by the NCAER (1994).
715. As is to be expected in a country of India’s immense size and widely differing resources from region to region, the very low per capita income in India is an average for the entire population of around one billion people. There are tremendous variations in the income levels of Indians, with two of them featuring amongst the world’s 50 richest persons, and more than 300 million below the poverty line.

Table 6.22: Per capita net state domestic product at current prices (Rs)
State
1994-95
1995-96
1996-97(P)
1997-98(Q)
1998-99(A)
A & N Island
10476
10911
12653
-
-
Andhra Pradesh
8145
9274
10806
10590
-
Arun. Pradesh
9417
11803
12032
13424
-
Assam
6017
6824
6928
7335
-
Bihar
3737
3533
4281
4654
-
Delhi
19954
21830
22687
-
-
Goa
16703
20141
23061
23482
-
Gujarat
11810
12914
14875
16251
-
Haryana
12283
13573
16392
17626
-
Him. Pradesh
7846
8747
-
-
-
J&K
5860
6231
6658
-
-
Karnataka
8504
9359
10504
11693
-
Kerala
7578
9004
10809
11936
-
M.P.
6034
6775
7571
8114
-
Maharashtra
13368
15770
17666
18365
-
Manipur
6542
6914
7510
8194
-
Meghalaya
6402
7862
8474
-
-
Mizoram
7743
9570
13360
-
-
Nagaland
8550
9758
11174
-
-
Orissa
5369
6236
5893
6767
-
Pondicherry
10489
11512
11677
-
-
Punjab
14534
16053
18006
19500
-
Rajasthan
6951
7523
8974
9356
9819
Sikkim
8869
9472
-
-
-
Tamil Nadu
9353
10222
11708
12989
-
Tripura
4366
5083
5432
5804
6200
Uttar Pradesh
5339
5872
6713
7263
-
West Bengal
7436
8491
9579
10636
-

(P) - Provisional
(Q) - Quick estimates

NA - Not Available

716. India’s middle class, one of the largest in the world, comprises educated professionals, businessmen and technocrats, who enjoy a good standard of living.


Programme Interventions

717. Poverty alleviation and employment generation programmes have been in operation since the beginning of the Five Year Plans. The specifically designed anti-poverty programmes for generation of self-employment and wage-employment in rural areas have been restructured to improve their impact on the poor.


Swarnajayanti Gram Swarozgar Yojana (SGSY)

718. The focus of development planning in India has rightly been on the alleviation of rural poverty since Independence. Rural India, however, continues to suffer from high incidence of poverty in spite of strong anti-poverty programmes in successive years. In percentage terms, poverty level has reduced from 56.44 per cent in 1973-74 to 37.27 per cent in 1993-94. In absolute terms, however, the number of rural poor has remained more or less static. It is estimated to be about 244 million. The adverse effect of such a large size of the poor on the country's development is not difficult to appreciate. It is in this context that self-employment programmes assume significance. The Swarnajayanti Gram Swarozgar Yojana (SGSY) has been launched with effect from 1 April, 1999. As a result, the erstwhile programmes, viz. Integrated Rural Development Programme (IRDP), Development of Women and Children in Rural Areas (DWCRA), Training of Rural Youth for Self-employment (TRYSEM), Supply of Improved Toolkits to Rural Artisans (SITRA), Ganga Kalyan Yojana (GKY) and Million Wells Scheme (MWS) ceased to be in operation. The SGSY has been devised keeping in view the positive aspects and deficiencies of the earlier programmes.


Jawahar Gram Samridhi Yojana (JGSY)

719. The primary objective of this programme is the creation of demand-driven village infrastructure, including durable assets at the village level to enable the rural poor to increase the opportunity of sustained employment and to generate supplementary employment for the unemployed rural poor. Under Jawahar Gram Samridhi Yojana (JGSY), 22.5 per cent of the annual allocation must be spent on beneficiary schemes for Scheduled Castes/ Scheduled Tribes and three per cent to be utilized for barrier-free infrastructure for the disabled. Another objective is to generate supplementary employment for the unemployed rural poor.
720. The Employment Assurance Scheme (EAS), launched in October 1993 in 1772 identified backward blocks situated in drought-prone, desert, tribal and hill areas has been restructured as a single wage-employment programme from April 1999. This programme is being implemented in all the 5448 blocks with a fixed annual outlay. The primary objective of the EAS is the creation of additional wage-employment opportunities during the period of acute shortage of wage-employment through manual work for rural poor living below the poverty line. The second objective is the creation of durable community, social and economic assets to sustain future employment and development. The zilla parishads are designated as the implementing authorities of the scheme.
721. The ongoing National Social Assistance Programme (NSAP) provides benefits under its three components, viz., National Old Pension Scheme, National Family Benefit Scheme and National Maternity Benefit Scheme. The Prime Minister’s Rozgar Yojana (PMRY) was launched in urban areas in 1993-94 and extended to rural areas from 1994-95 for providing self-employment to the educated unemployed. It attempted to generate employment for more than a million persons by setting up 700,000 micro-enterprises during 1992-1997. The scheme continues in the Ninth Plan with certain modifications, and a target of 220,000 beneficiaries has been fixed for 1999-2000.


Swarna Jayanti Shahari Rozgar Yojana

722. The Swarna Jayanti Shahari Rozgar Yojana (SJSRY), which subsumed the earlier three urban poverty programmes, viz., Nehru Rozgar Yojana (NRY), Urban Basic Services for the Poor (UBSP) and the Prime Minister’s Integrated Urban Poverty Alleviation Programme (PMIUPEP), came into operation from December 1997. It sought to provide employment to the urban unemployed or underemployed poor living below the poverty line and educated up to standard IX through encouraging the setting up of self-employment ventures or provision of wage-employment. The scheme gave special impetus to the empowerment and upliftment of poor women, and launches a special programme, the Development of Women and Children in Urban Areas (DWCUA), under which groups of poor urban women setting up self- employment ventures are eligible for subsidy up to 50 per cent of the project cost.10


Housing

723. The GOI has been implementing the Indira Awaas Yojana (Indira Housing Scheme) since 1985-86 with the objective of providing dwelling units free of cost to the members of the Scheduled Castes/Scheduled Tribes and freed bonded labourers living below the poverty line in the rural areas.
724. The Samagra Awaas Yojana (Universal Housing Scheme) is another comprehensive housing scheme launched recently with a view to ensuring an integrated provision of shelter, sanitation and drinking water. It has been decided to take up the Samagra Awaas Yojana on a pilot basis in one block in each of the 25 districts of 24 States and one Union Territory, which have been identified for implementing the participatory approach under the Accelerated Rural Water Supply Programme.
725. HUDCO shall proactively intervene to ensure adequate geographical distribution of the benefits under its Rural Housing Scheme. The National Mission for Rural Housing and Habitat has been set up by the Ministry of Rural Development to facilitate the induction of science and technology inputs on a continuous basis into the sector. It would provide convergence of technology, habitat and energy-related issues with a view to providing affordable shelter to all in rural areas within a specified time-frame and through community participation.11
726. The United Nations Centre for Human Settlements (UNCHS) was established through a resolution of the UN General Assembly for guiding habitat activities. India has been a member of the organisation since its inception. An annual contribution of US$ 100,000 payable in Indian currency, is made by India. The Minister of Rural Development has been closely associated with the activities of UNHCS.
727. The second UNCHS (Habitat II in Istanbul 1996) supported the habitat agenda and the experts. It declares that the need of the children and the youth, particularly with regard to their living environment, have to be taken fully into account. Special attention needs to be paid to the participatory processes dealing with the shaping of cities, towns and neighbourhoods. This is in order to secure the living conditions of children and youth, to make use of their insight, creativity and thoughts on the environment. Special attention must be paid to the shelter needs of vulnerable children such as street children, refugee children, and children who are victims of sexual exploitation.12

SECTION VII

EDUCATION, LEISURE AND CULTURAL ACTIVITIES

(Arts. 28, 29, 31)

A. Education, including Vocational Training and Guidance

Article 28

Introduction1

728. The national policies of education in India have always underscored the Constitutional resolve to provide quality education to all. Education being a concurrent subject, partnerships between the Central and State Governments have been the basis for implementing a large number of centrally sponsored initiatives. In order to focus on the urgency of achieving universal elementary education and literacy, a separate Department of Elementary Education and Literacy has been created recently, which together with the Department of Secondary and Higher Education, has introduced a number of initiatives in order to meet the needs of human resource development in a rapidly changing world. While doing so, the promotion of excellence and equity in education has been the major concern.
729. The provision of Universal Elementary Education (UEE) has been a salient feature of India’s national policy. The Hon'ble Supreme Court, in its order in the Unni Krishnan Case (1993), has declared education of children up to the age of 14 years a fundamental right. Recent household surveys confirm that nearly 79 per cent of children in the 6–14 years age group are attending schools. In order to mainstream children who are at present out of school and to improve the quality of instruction for those in school, the Government has been making concerted efforts. Some of the major initiatives are:

Box 7.1: Sarva Shiksha Abhiyaan
The Sarva Shiksha Abhiyaan (SSA) has been launched to ensure that every child in the 6–14 years age-group is either in a school, education guarantee centre, or a back-to-school camp by 2003. It has also been decided to ensure five years of primary schooling for every child in India by 2007 and eight years of elementary schooling by 2010. In order to improve the quality of learning, curricular framework has been reviewed to make it more relevant to life and promote competency-based learning. Work education, value education and activity-based learning are being facilitated in the process of the curricular review. Community ownership and effective monitoring by the elected Panchayati Raj (local self-government) and urban local body representatives are being attempted in the SSA.

Source: Annual Report 2000-2001, Department of Elementary Education & Literacy, Department of Secondary and Higher Education, Ministry of Human Resource Development, GOI

731. Initiatives for deprived children in urban areas are already under way in Mumbai, and other such urban projects are likely to start in Calcutta, Delhi, Bangalore, Ahmedabad, Hyderabad, and other cities. The education of girls is a priority and efforts to facilitate learning opportunities for them are being made. The 148 districts with low female literacy among the Scheduled Castes/Scheduled Tribes are being targeted as a priority under the SSA.
732. In the realm of secondary education, the National Council for Educational Research and Training (NCERT) has initiated a review of the curriculum framework, and the Central Board of Secondary Education (CBSE) has introduced a system of comprehensive evaluation in its schools over the years. NCERT’s new curriculum design focuses on the objectives of skill building, acquisition of competencies and understanding of the issues relevant to the needs of a child. The school-based evaluation by the CBSE has tried to capture the overall cognitive development of a child, so far ignored by the school evaluation process, by adopting a grade system for each subject at the Class X stage.
733. The Justice Verma Committee constituted by the Government highlighted the need for inculcating knowledge about fundamental duties enshrined in the Constitution as a curriculum concern among students. Information technology (IT) in schools was another curriculum area addressed by the Government with the introduction of new syllabi based on IT. Given the fact that less than two per cent children with disabilities—out of a total of over 16 million—have joined the school system, programmes for attitudinal changes, capacity-building among teachers and training institutions to educate these children in inclusive school settings have also been taken up by the Government.
734. The National Open School (NOS) entered the elementary education sector in a significant way, particularly for children who are not reached by the regular school system. These include working children, children with disabilities and children from other marginalized groups.
735. Similarly, due attention is being paid to vocational education to meet the learning needs of school dropouts, as well as regular students who wish to adopt the vocational system. Schemes to promote computer literacy in schools are also being revised to provide for computer literacy in at least 10,000 secondary schools of the country. The Kendriya Vidyalaya Sangathan (KVS) and Navodaya Vidyalaya Sangathan (NVS) have resolved to provide computer literacy in all their schools.
736. Schemes for modernization of madrasas (school for religious instruction for Muslims) and area-intensive schemes for minorities have been a priority and are being regularly monitored. The aim is to have a focused and convergent approach for implementing all the programmes for minorities in the 331 blocks with a significant minority population.
737. In the area of higher education, while all attempts are being made in the formal education sector to increase access, the open university system with the Indira Gandhi National Open University (IGNOU) at its apex, has dramatically improved access through its network of regional and study centres.
738. In recent years, there have also been a large number of State-specific initiatives. For instance, Andhra Pradesh has adopted an innovative elected school management committee approach for improving community ownership of schools. Madhya Pradesh and Uttar Pradesh have decentralized management of education to Panchayati Raj (local self-government) institutions and urban local bodies. States like West Bengal have drawn up plans for Universal Elementary Education (UEE). Bihar has launched an attendance scholarship scheme for children from families below the poverty line. These efforts reflect recent interest across educationally backward States to provide quality elementary education to all children up to 14 years of age.


Overview
Constitutional, legislative and policy provisions, planning and monitoring

739. According to the Constitution of India, primary and elementary schooling are required to be provided free of cost to all citizens, implying that neither school enrolment nor continuation rates should differ across States and socio-economic groups.

740. A holistic view was taken in 1986 when the National Policy for Education (NPE) visualized education as a dynamic, cumulative, life-long process, providing diversity of learning opportunities to all segments of society. The NPE, 1986, as well as its Programme of Action (POA), which was the result of deliberations, consultations and consensus, was reviewed and updated in 1992. The introductory part of the POA envisages that given the rich diversity of our nation it would be in the fitness of things if each State and Union Territory formulates a State POA in accordance with its situational imperatives, as well as with the POA, 1992.2 The task of implementing NPE and POA lies with States and UTs, and the Centre was to monitor the implementation. Accordingly, the POA was circulated to all States and UTs to draw their own State Programme of Action (SPOA). Besides implementation by the States and UTs, Central ministries and departments, the Planning Commission, autonomous organisations and bureaus in the Department of Education were to take action on NPE and POA. However, the implementation and formulation of SPOAs by State Governments require intensification.

741 A comprehensive review of the education situation was held in New Delhi in November 1999 by the education departments of the Centre and all the States/UTs. Representatives from professional bodies and NGOs also participated in the review, which identified the steps to be taken. These were:

Box 7.2: Recent trends towards structural reforms in
elementary education in India
Elementary education is recognised as a fundamental right of all citizens in India. The Supreme Court of India, in its judgement in the Unni Krishnan Case (1993), has held that all citizens have a fundamental right to education up to the age of 14 years. The GOI introduced the 83rd Constitutional Amendment Bill in Parliament in 1997, to make education a fundamental right of all children between 6–14 years;
Greater emphasis on decentralisation of educational planning and administration. The 73rd and 74th Constitutional Amendments have provided a statutory base for decentralised educational planning;
Multi-sectoral holistic approach to UEE;
Greatest stress on creation of conditions that would encourage increased community participation in effective school management and supervision;
Re-examination of relationship among the Government, NGOs and private institutions to harness potential non-governmental institutions in pursuit of UEE;
Recognition of limitations of market forces in ensuring equity and equality in elementary education. The Government is committed to enhancing financial allocation for education to six per cent of the GDP; and
Greater thrust on community-based support structures, educational planning and monitoring and evaluation to improve elivery of elementary education.

Source: Janshala Newsletter, Vol. II, Issue 1, January 1999, GOI

743. The proposed 83rd Constitutional Amendment Bill, 1997, guarantees the right to free and compulsory education for children from 6–14 years of age. It also makes it a fundamental duty of parents/guardians to provide opportunities for education to children in this age group.4
744. The Tamil Nadu Compulsory Education Act, 1994, came into force from July 1998. Art. 4 of the Act makes it a duty of every parent or guardian to send their ward to attend an elementary school if he or she is of the school-going age. On failure, the parent or guardian shall be punished with a fine, which may extend to one hundred rupees. Further, to safeguard the interest of families, it is listed as a cognizable offence, where no court shall take cognizance of the offence punishable under this Act, unless and until the complaint is given in writing by an officer authorized by the Government in this regard.5
745. The Government has declared its commitment to every child in the Ninth Plan (19972002). The challenge is to reach every young child and his/her family, especially the disadvantaged, with the active participation of the community, to promote holistic development and growth. The approach to the Ninth Five-Year Plan has been formulated in the light of these objectives. The total central plan allocation on education has been enhanced from Rs 40.54 billion in 1998–99 (RE) to Rs 47 billion in 1999–2000 (BE).6


Organization and structure

746. The Department of Education was one of the constituent units of the Ministry of Human Resource Development (MHRD) till October 1999, when the Department of Culture and Youth Affairs and Sports was put under a separate ministry. In order to give a thrust to the activities relating to elementary education and literacy, the erstwhile Department of Education has also been reorganised, creating a separate Department of Elementary Education and Literacy. The remaining activities of the Department of Education are to be handled in the redesignated Department of Secondary Education and Higher Education. In matters relating to these two departments, the Minister for Human Resource Development is assisted by a Minister of State. Each Department is headed by a Secretary to the Government of India (GOI).
747. The Department is organized into bureaux, divisions, branches, sections and units. Each bureaux is under the charge of a Joint Secretary or Joint Educational Advisor, an officer of equivalent rank.7
748. School education in India comprises four levels: primary, upper primary, secondary and higher secondary. The National Policies on Education (1968 and 1986, and the latter’s revised formulation of 1992) envisaged a uniform (10+2) pattern of school education across States. Although education is on the concurrent list, States are free to evolve their own pattern of school education. Eight years of elementary education comprise two stages: a primary stage of classes I–V and an upper primary stage of classes VI–VIII. However, eight years of compulsory education have been envisaged as one integrated unit. The official age of entry to class 1 is six years but in a few States, it is five years. The Government has recently decided to introduce a Constitutional Amendment Bill which will make elementary education a fundamental right. This will be implemented as part of the Sarva Shiksha Abhiyan. In fact, some States such as Kerala have already made elementary education compulsory.
749. Like elementary education, classes comprising secondary education differ in States. While secondary stage consists of classes IX and X in 19 States, it consists of classes VIII, IX and X in 13 States. Within a State, however, complete uniformity prevails. Government, local bodies and private managements maintain schools. In addition, private educational institutions, both in rural and urban areas, also exist in large numbers.
750. In most States, after 10 years of schooling, 2+3+2+ pattern is prevalent, which consists of two years of higher secondary education, three years of first degree education and two years of postgraduate education.8


Current literacy situation

751. Education, the most crucial investment in human development, is an instrument for developing an economically prosperous society and for ensuring equity and social justice. Despite Governmental efforts at UEE, half the adult Indian population continues to be illiterate, and two thirds of women are illiterate. The literacy rate for rural India as a whole is 54 per cent: 66 per cent for males and 40 per cent for females, with a gender disparity of about 40 per cent9 (Census 2001).
752. However, recent estimates of literacy at the national level have shown a significant increase from 52 per cent in 1991 to 62 per cent in 1997. The increase was significant among the educationally backward States. Large-scale expansion of formal primary education in the early 90s and innovative strategies of primary education development projects like DPEP have contributed substantially to these outcomes. Nonetheless, inter-/intraState level variations are large.
753. The National Sample Survey Organisation (NSSO) conducts regular surveys to assess literacy rates. It takes samples of 40,000 households each year and 120,000 households every five years. The NSSO has updated the exercise up to December 1997, including therein the results obtained in the process of conducting the 53rd round. NSSO has also estimated up to the end of 1998. The NSSO survey 10 results are shown in the figures 7.1 and 7.2.
754. The survey shows an increase of 10 percentage points between 1991 and 1997 (a timeframe of just six years) and 12 percentage points between 1991 and 1998 (a gap of just seven years). Significantly, the rise in female literacy between 1991 and 1997 has been 11 per cent, whereas male literacy rate has risen by nine per cent during the same period. In the previous decade also, female literacy had grown faster than male literacy. Thus, the faster rate of growth among females has not only been maintained but also slightly enhanced. The differential has dropped by more than four per cent during the six year period 1991–97. The gap between rural and urban literacy levels is narrowing.

755. There are gender disparities and dispa