- Soham Agarwal and Abhinav Kumar Singh
The Future in Gloom: Early Childhood Care in India
Since Independence, India has shown tremendous performance on the world platform; from establishing itself as a democratic nation to achieving high economic progress and getting itself to be recognised as a responsible nuclear state with proven industrial and scientific capacities. It has also achieved remarkable progress on social fronts like literacy rate, women development and so on. Despite these achievements, a lack of proper early childhood care remains a blot and continues to be a major hindrance in the nation’s aspirations.
Sometimes, it happens that the most important arena of life remains untouched and that is exactly what happened with Nourishment and Early Childhood Care in India. The matter has almost disappeared from the social and political talks and is often not recognised as a priority for any government in India.
This fact was reflected in an analysis done by an NGO named HAQ: Centre for Child Rights, published in Parliament Watch- 2018-19. According to this, India's 37% population consists of children in the age group of 0-18 years. The NGO analysed questions raised by Parliamentarians in both Houses of the Indian Parliament and it was found that in the year 2017-18, out of the total questions asked in the parliament, only 3.3% were related to children. In the year 2018-19, the percentage was 4.3%.
Not only this, even out of these questions less than 5% were related to the Early Childhood State (Children between the age group of 0-6 Years). We shall analyse this aspect further in two parts: The Nourishment Part for the age group of 0-3 Years and the early childhood education for the age group of 3-6 years.
Age Group 0-3 Years
Just imagine a situation: A gardener who grows flowers allows others to trample them and then tries to correct this mistake by giving plenty of water and fertilizers to that plant.
In India, the government is doing the same to children as there are no public efforts and initiatives to take care of them until they are sent off to schools for education and care (if they are lucky enough for this too though).
Though India has achieved remarkable progress since independence in nutrition-related indicators like Mother Mortality Rate, Child Mortality Rate, also the numbers of severely malnourished children significantly decreasing, it still categorizes with the bottom-rung nations of the world. Today, malnourishment is an extremely serious condition in India and South Asia. Recently, in the report of Global Hunger Index- 2021, India has fallen to 101st (out of 116 countries) position from 94th (out of 107 countries) position last year in 2020. The GHI is an annual report which measures and tracks hunger globally as well as by country. This report is jointly published by an Ireland based agency- Concern Worldwide and German organization- Welthungerhilfe and has worldwide acceptability. The report is based on four following indicators.
1. Child Wasting: This is the share of children (under the age of 5) in the total population, who have low weight for their height, reflecting acute under-nutrition
2. Undernourishment: It is the share of the population with insufficient caloric intake.
3. Child Stunting: It is the share of children (under the age of 5), who have low height for their age, reflecting chronic under-nutrition.
4. Child Mortality: Child Mortality Rate- The child mortality rate (CMR) refers to the probability of dying between birth and exactly five years of age expressed per 1,000 live births. It encompasses neonatal mortality and infant mortality.
According to the report, India has a score of 27.5 on a level of 0-100, with a serious condition of hunger in the nation. The report also said that wasting among children in India increased from 17.1% between 1998 and 2002 to 17.3% between 2016 and 2020. While Child Stunting has significantly decreased from 54.2% in 1998-1999 to 34.7% in 2016-2018 - it is still considered very high. The CMR in India is 3.4% and has decreased significantly from 9.2% in the 2000s.
In another report of the Indian Council of Medical Research, released in 2019, out of 1.4 million children dying every year in the country, more than 0.7 million deaths occur only due to malnutrition. In this scenario, 32.7% of Indian children are suffering from wasting and 59.7% are anaemic. 54.4% of Indian girls between the age group of 14-19 years are anaemic.
It is often claimed that child malnutrition in India is just a myth as children in India are relatively short in height due to genetic factors, therefore international standards of anthropometry do not apply to them. However, till now this so-called “short but healthy” concept hasn’t got any scientific approval so far.
In the World Health Organization (WHO) Multicentre Growth Reference Study (MGRS) conducted in India in 2006, a large number of children from prosperous families of South Delhi were included, in which at least one member had completed a minimum of 17 years of education and in addition, there were conditions conducive to mothers and child care. It was found in the report that those children, raised in privileged and friendly environments, grew up in terms of height and age ratio at different ages, in the same way as children of countries included in the WHO study – Brazil, Ghana, Norway, Oman, America.
This trend of high levels of child malnutrition in South Asia (not only India), which is comparable to that in sub-Saharan Africa with poorer income and health indicators, is called the “South Asian Enigma”. The one thing that should not be forgotten in the matter is that apart from child malnourishment, India also has the highest number of anaemic women in the world, higher than any other country. According to the Global Nutrition Report-2020, 50% of Indian women are found to be anaemic in their reproductive age.
The main reason behind this is that the topic of nourishment is not taken into any priority and left unaddressed by society and political class, despite there being a complete lack of social awareness and consciousness towards it. One big reason for the unceasing negligence towards child care in India is the prevalence of the notion that early childhood care should be completely left to their families, as children can be taken care of best by them. But parents, generally, are not fully aware of the proper early childhood care, or rather do not have the complete resources to do so. This got reflected in a survey done on children in Uttar Pradesh. Half the children included were found to be malnourished, yet 94% of the mothers reported their children’s status as ‘normal’. Mostly, what parents do for their children, (like vaccination, the regular dosage of a pregnant woman and her foetus, etc.), depends on the prevalent societal norms which may have positive effects when implemented publicly. The prevalent misconceptions and superstitions in society impact the child's health and development adversely. For example, misconception about breastfeeding, prohibiting eatables for pregnant ladies (supposed to be given) ; women working till the last stage of pregnancy, lifting heavy weights, not getting a healthy environment and so on. Many issues clearly articulate that the upbringing of children cannot solely be left to their families; instead it is a collective responsibility of the society.
It has been very well articulated in various research papers and proved in scientific experiments that most of the development of humans takes place in the first 6 years of age, which has a decisive and long-lasting impact on the child’s health, psychology, attitude, skills and future opportunities. In this, the first 1,000 days of life - roughly from conception to one's second birthday - are a once-in-a-lifetime opportunity to lay the groundwork for maximum health, growth, and neurodevelopment throughout one's lifetime. While the human brain continues to develop and alter throughout life, the last trimester of pregnancy and the first two years of life are the most rapid periods of brain growth and plasticity. At 5 months after conception, the human brain is a smooth, bi-lobed structure that resembles a coffee bean. It possesses gyri and sulci, indicative of significant complexity by 9 months, i.e. term birth, and looks far more like the walnut-like adult brain. The hippocampus, as well as the visual and auditory cortices, are the rapidly developing brain areas at birth. The language processing areas expand rapidly in the first year after birth, as does the prefrontal cortex, which will handle "higher processing" such as attention, inhibition, and flexibility. Rapid neuronal proliferation (cell counts), development and differentiation (complexity), myelination, and synaptogenesis define the first 1,000 days (connectivity). As a result, this is the best time to offer adequate nutrition to maintain normal development, as well as the time when the brain is most vulnerable to nutrient deficiencies. While all nutrients are crucial for brain growth and function, feeding sufficient amounts of key nutrients during specific sensitive periods in the first 1,000 days is critical for good overall brain development. Yet too frequently, as discussed earlier, in India, poverty and its attendant condition, malnutrition, weaken this foundation, leading to earlier mortality and significant morbidities such as poor health, and more insidiously, substantial loss of neurodevelopmental potential.
Theoretically, much of its scope seems to be in the Integrated Child Development Services (ICDS), which is the only national programme for children below the age of 6 years. Also, it is one of the largest nutrition-based programmes in the world, launched in India in 1975, currently with 1.377 million Anganwadi Centres and having more than 2.5 million honorarium workers in the entire country. These Anganwadi centres provide 6 kinds of services to children between the age group of 0-6 years, pregnant women, lactating mothers etc. These are Supplementary Nutrition, Immunization, Health check-up, Referral Services, Nutrition and Health Education and Pre-school Education.
Age Group 0-6 Years and Pre School Education
As discussed earlier, the first few years of a child's existence are the most remarkable era of growth and development. During these years, the foundations of all learning are laid. Getting the foundations right has several long-term benefits, including improved learning in school and higher educational attainment, which leads to significant social and economic benefits for society and the kid.
Various studies have shown that strong early childhood education reduces the likelihood of dropout and repeat, and increases educational outcomes at all levels. Pre-primary education provides children with a strong foundation upon which all subsequent learning is built, making each stage of education more efficient and productive.
Pre-school education in India is delivered through Integrated Child Development Services (ICDS), which is a central sponsored and state-administered early childhood development programme. In awareness of the importance of investing in early childhood development, especially early childhood education (ECE), and the impact on lifelong development, the Indian government established the National Early Childhood Care and Education (ECCE) policy in 2013. The National ECCE Curriculum Framework guides this policy. According to a poll, nearly eight out of ten children (between 3-6 years of age) are enrolled in some type of ECCE programme.
Anganwadi System in India and Pre School Education
Integrated child development services are provided through a network of over 1.3 million Anganwadi facilities located throughout the country. According to the Ministry of Women and Child Development, every region with a population of 400 to 800 people has at least one Anganwadi facility. An Anganwadi Worker (AWW) looks after the women and children in these centres. An Anganwadi helper, an auxiliary nurse who provides services to pregnant women, and an Accredited Social Health Activist (ASHA) who provides services such as first aid, special needs referrals and counselling, complement the AWW. Anganwadi facilities have shown to be quite effective in providing pre-school services to children, as well as providing food rations to lactating and pregnant women.
At these centres, children between the age group of 3-6 years are provided with pre-school education under the National Early Childhood Care and Education (ECCE) policy. There is a set curriculum for this and a pre-school education kit is provided to each Anganwadi centre in order of the curriculum. This kit has a variety of things like- Puppets/Dolls, Building Blocks, Props for dramatic play, String and Beads, Slates, Different Educational Toys, Puzzles, Colours, Reading materials/flip books etc. These are used for teaching different activities to the children and this concept of “Play-Based Learning” develops the kid in various ways.
The objective of the development is:
1. Sensory and Perceptual Development: Demonstrate the use of several senses (sight, hearing, feeling, tasting, smelling) to guide movements and detect objects, as well as knowledge of space and direction, distance, number, and other concepts.
2. Physical Health and Motor Development: Coordination and control of large and small motor muscles are developed.
3. Language Development: Improve their listening and comprehension skills, as well as their expressive and receptive communication abilities.
Effects of Pandemic on ECE:
Covid-19 has had a permanent, irreversible and irredeemable effect on the early education of children aged between 3-6 years. For approximately 2 years, Anganwadi centres were closed and it made a severe impact on the early education of children. Pre-schools, NGO and private schools were shut down during the pandemic, with very few of them running online classes. Also, not everyone could afford mobile phones, did not have internet access etc. Online education is proving ineffective when it comes to ECE as it lacks real interaction and physical proximity with the teacher and classmates.
“Education disruptions caused by the COVID-19 pandemic are preventing children from getting their education off to the best possible start,” said UNICEF Executive Director Henrietta Fore. “Childcare and early childhood education build a foundation upon which every aspect of children’s development relies. The pandemic is putting that foundation under serious threat.”
COVID-19, according to experts, has caused the continuing ECE infrastructure to crumble. The question of how to provide crucial ECE to children two years after the pandemic ravaged India still looms large. Recently a new variant of Sars-Cov-2 virus B.1.1.529 named Omicron has been declared as VOC (Virus of Concern) by the WHO on 26th November 2021, looming over the bleak possibility of normal life soon ahead. It further exacerbates the ECE and will adversely impact the future of the country.
ECE is a matter of big concern and is extremely time-sensitive. As a result, this issue must be handled immediately; that alternatives be devised quickly, and that children begin to receive the fundamental pre-school education that they need, not just for the future of the children, but for the future of the entire society. It has been emphasised that ECE must be redesigned in the short to medium term using all available methodologies.
Positive parenting is, first and foremost, a requirement of the hour. The involvement of parents in the process must expand. Teachers/AWWs must develop SOPs that instruct parents on how to ensure that their children receive the requisite ECE. Online classes involving both parents and children can be scheduled whenever possible. The most pressing worry here is time availability, particularly in circumstances where both parents work, while also doing home tasks. Policies that assist parents' income and livelihood will go a long way towards ensuring that they engage in the ECE process.
Secondly, continuing education through the online medium is a big concern. Long durations of screen exposure has bad effects on children, so they must have very little or no screen time. Recently, the government of Karnataka banned online classes for children up to the fifth standard. Apart from this, the mode is not accessible to all and has great disparity when it comes to these services. Civil rights experts have emphasised that the online mode cannot be considered as a viable alternative to ECE for the vast majority of India’s children. Instead of this, children should be reached out to via the traditional media – television and radio. All TV channels should be restricted to streaming these ECE videos, designed by experts, at a particular time every day. This will increase accessibility to a great extent when compared to computers and internet-based solutions, and may be able to partially (though not completely) compensate for the loss of pre-schooling of children in the country. Kerala has already started streaming classes for older children via television.
AWWs can reach out to children by using novel approaches and practising social distancing rules; such as seeing children in small batches throughout the day rather than in indoor classrooms. Green zones can be used to test these ideas.
And lastly, the government must intervene and take action. Though ECE is included in the New Education Policy 2020, governments must take action by determining what needs to be done. It should enlist the help of specialists in the field and develop SOPs for the current scenario. In addition, attention should be paid to a long-standing civil society demand: modifying the Right to Education Act to include ECE in its scope. A recent UNICEF report also emphasised the need for the government to considerably increase financing for ECE.
Nobel Laureate Gabriela Mistral said, “We are guilty of many errors and many faults, but our worst crime is abandoning the children, neglecting the fountain of life. Many of the things we need can wait. The child cannot. To him, we cannot answer ‘Tomorrow’. His name is today”.
It is a pressing need of the hour that all possible approaches are employed according to feasibility, and the children receive what is owed to them for a better tomorrow. This throws a lot of challenges and needs a wider stakeholder involvement but it is the responsibility of the adult community to ensure the invisible rights of children, and not lose any more precious time. We must look into this matter now and do the needful by our collective efforts. If we do not pay attention to this issue today, then surely we will not be able to enter the future as a superpower.
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