Half of the children in the slums of the national capital are underweight, according to a study conducted by volunteers of CRY– Child Rights and You for children between the ages of 1 to 6 years. The children do not fare any better with respect to the other indicators of malnutrition, with 43 percent found to be wasted. The percentage of children found to be suffering from stunting stands at 45 percent, even though it has shown a marginal improvement from the NFHS figure of 51 percent in 2005-06.
Nutrition and immunization are the most critical for a child’s survival in the first six years of his or her life. Shockingly, even the immunization coverage in the slums in Delhi is much worse than expected. Less than one third of the children (about 31 percent), under the age of three years, have received at least one dose of recommended vaccination. A gender imbalance is seen here with only 25 percent of the girls receiving at least one dose, as compared to 39 percent of the boys.
These children dwelling in the most underprivileged sections of the city, most of them belonging to migrant families bear the maximum impact of urban poverty; especially in the absence of caregivers, who are mostly engaged in informal economic roles.
This household survey on early childhood was conducted in slums across five major metropolitans in India namely Delhi, Mumbai, Chennai, Bangalore and Kolkata. The slums in the five metros do not show a positive trend with respect to child nutrition. Chennai has the most number of children battling malnutrition in its slums, with 62.2 percent being underweight; Kolkata and Mumbai slums have 49 and 41 percent underweight children, accordingly to this study. Bangalore fares slightly better, with 33 percent children found to be underweight. About 43 percent children across all the metros were not fully vaccinated.
Even as Aanganwadi Centres (AWCs) remain one of the most important institutions for ensuring nutrition, health and early education of children below 6 years, only 46 percent children dwelling in slums are enrolled. In the national capital, the enrollment in AWCs in slum children stood at a despondent figure of 47 percent. The ICDS scheme also provides for health services including de-worming, IFA (Iron and Folic Acid tablets) and Vitamin A dosage. More than a third of the children in the 5 cities surveyed had not been de-wormed. In Delhi, half the children did not receive the Vitamin A and IFA supplement and about a third had not been de-wormed.
The study points out that the service provision to children is more effective in Aanganwadis than in other institutions. This is reflected in the fact that children going to private pre schools and other institutions are not receiving essential services for their health and survival. For instance, 73 percent children enrolled in Aanganwadis receive the Vitamin A dose compared to only 52 percent in private preschools. However, while the Aanganwadi worker is providing the services within the institution, provisioning services through community outreach remains a challenge. An indicator that substantiates the gap between the service and the community is the fact that though growth monitoring was done for 70 percent of children only 48 percent of parents were informed. In Delhi, for instance, 60 percent of parents were not informed that their child is malnourished.
While there is an evident need for improvement, the study shows significant positive perception of parents towards Aanganwadi centres. 96 percent of parents feel safe in sending their child to AWCs and 82 percent perceive the Aanganwadi to be child friendly.
Soha Moitra, the Regional Director, North for CRY said, “Early childhood, spanning from birth to the age of six years, is the crucial period when the foundations of cognitive, physical and socio-emotional development, language and personality are laid. It is also the phase of maximum vulnerability as deprivation can seriously impact a child’s health and learning potential. Therefore we need to ensure that children in this age group get the best of nutrition, health and learning.”
She added, “CRY strongly recommends that health, nutrition and care to children should be provided as entitlements. Nutrition security of these children should be addressed with urgency. Alternate care arrangements like crèches for all children are a non negotiable in light of informal economy in urban slums where both parents are compelled to work for sustenance.”
The study forms a part of ‘Healthy Start’ initiative by CRY, which is focused on the importance of ensuring children in the age group of 0-6 receive essential care, nutrition and education. Within the ambit of Healthy Start, CRY has launched ‘Get Healthy Give Healthy’ campaign which is about encouraging people to raise funds for a healthy start for young children, while working towards a personal health goal.