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State Table 14: Nutritional status of children – aged 6-60 months Number of children Level of malnutrition Wt for age Under nutrition Ht for age Stunting Wt for Ht Wasting Uttar Pradesh 22 Severe (-3SD) Moderate (-2SD)-* 7 10 3 6 1 6 Severe (-3SD) 4 9 0 Karnataka 18 Moderate (-2SD)-* 11 13 3 Severe (-3SD) 1 2 0 Andhra Pradesh 23 Moderate (-2SD)-* 3 3 0 Total states for 3 63 Severe (-3SD) Moderate (-2SD)-* 12 24 14 22 1 9 Source: Household Survey Data *Includes –3SD ** The above ‘Z’ Scores are obtained using NCHS standards through ‘EPINFO’ package of WHO of measured anthropometrical measurements of height and weight and reported approximate age in months in AP Schools. As evident from Table 14 on nutritional status of 6 to 60 months, mortality rates for the under- five age group were high in all the three states. Even though the sample studied is very small and statistically insignificant, we apprehend higher deprivation and vulnerability of population living in urban slums in all states. In the case of Andhra Pradesh, contrary to experiences in Karnataka and Uttar Pradesh, the situation in the centrally located slum was far worse than the periphery, specially if one looks at the under five years mortality. Is it because of greater of environmental pollution/ sheer poverty/ lack of coping mechanisms vis-à-vis pressures of modern life, despite better access to health facilities? Box 5: The positive impact of enriched day-care The Infant Health Development Project cited by Mary. E. Young at the International conference on Early Childhood Care for Survival Growth and Development in India, 2000, was a longitudinal randomized state trial for the effectiveness of Early Childhood Development (ECD) and family support services for 1000 LBW premature babies till 3 years. Between 12–36 months, they were placed in enriched daycare centres; it was found that children of the poorest and least educated mothers gained the most. They sustained higher IQ and verbal scores; they also had fewer behavioral problems… Family-related determinants also play an important role in the child's health and nutrition. Malnutrition never occurs alone, it occurs in conjunction with low income, poor housing, family disorganization and the climate of apathy, ignorance and despair. Sub-culture influences within the home environment, the psychosocial climate, the role of the mothering person, intra-familial conditions are all responsible for the ill consequences of malnutrition (Vazir et al, 1988). Source: Conceptual Framework, New Concept, 2003 Though there was no shortage of water in both rural and urban areas, yet hygiene was poor and most children were unclothed or unkempt with uncombed hair, unwashed face and unbathed Educational Resource Unit Page 36 April 2003
odies. Running noses, skin rashes and boils were a fairly common sight. Close to 64% of children in Uttar Pradesh and 83% children in Karnataka reported that they suffered from some ailment during the last three months. In Andhra Pradesh 37% children were suffering from some ailment during the field visit. Drinking Water Source of water 83%-Bore water 11%-Piped Table 15: Health related Practices in 3 States Uttar Pradesh Karnataka Andhra Pradesh protected water 44%-Municipal 17%-Hand pump 39%-Water Tank 66%-Bore water 38%-Protected water 11%-open well water Sanitation Water dispensing All unsafe All unsafe All unsafe practices practices practices Defecation All in open 17% use Toilets All in open public places public places (only in urban) Hand washing None None None habits-with soap Pollution Exposure to Fire wood Smoke 100% 100% 100% Exposure to allergens NA NA Wild growth of Parthenium in rural and peripheral urban habitations Density-Crowding in house 7.1 7.2 7.5 Alcohol consumption - Head of HH 11% 11% 11% Source: Field survey data, 2002 Even though a majority of the houses obtain drinking water from tube-wells and protected water supply schemes, the incidence of water borne diseases is still high. This could be due to lack of sanitation and poor personal hygiene as indicated by the total lack of good practices for water dispensing, hand washing habits with soap at appropriate times both at the household and school level. There is a need for a massive campaign for personal hygiene and water storage and dispensing. Exposure to smoke is very high in all the observed habitations as firewood is the main fuel used and there is no separate cooking space. These factors may also be contributing to low birth weights. Educational Resource Unit Page 37 April 2003
Page 1 and 2: Publication released by World Bank
Page 3 and 4: Acknowledgements My first and heart
Page 5 and 6: LIST OF TABLES Table 1: ICD Concept
Page 7 and 8: GLOSSARY Ab iska kahan fayada hota
Page 9 and 10: Taluka Administrative unit - often
Page 11 and 12: concentric domains that span proxim
Page 13 and 14: Taking its cue from the above frame
Page 15 and 16: The rising cost of healthcare can h
Page 17 and 18: This emerging phenomenon of ‘hier
Page 19 and 20: day workshop in Hyderabad in late A
Page 21 and 22: Profile of the study area: Key indi
Page 23 and 24: stable, Uttar Pradesh continues to
Page 25 and 26: Village Village 1 UP Village 2 UP V
Page 27 and 28: SECTION TWO: THROUGH THE LIFE CYCLE
Page 29 and 30: implicated, wholly or partially, in
Page 31 and 32: women. Since, most children began t
Page 33 and 34: families… The incidence of low bi
Page 35: Box 4: Devdasi woman of Karnataka K
Page 39 and 40: low, as is knowledge about the link
Page 41 and 42: Box 7: Glimpse of healthcare facili
Page 43 and 44: years, in our sample, suffer from e
Page 45 and 46: Measurements taken in the course of
Page 47 and 48: The problem of irregular food suppl
Page 49 and 50: Box 10: The Aanganwadi worker of th
Page 51 and 52: other services (looking after the c
Page 53 and 54: women who are pregnant and those wh
Page 55 and 56: completed primary education, 13 nev
Page 57 and 58: The same issue was reiterated as we
Page 59 and 60: instance, let us take the example o
Page 61 and 62: gradually becoming more common. Wha
Page 63 and 64: desired. In Uttar Pradesh free text
Page 65 and 66: fuzzy. Learning outcomes are integr
Page 67 and 68: discussed earlier, dry rations seem
Page 69 and 70: mixed village pointing to the need
Page 71 and 72: and further fragment the experience
Page 73 and 74: poverty line. The households survey
Page 75 and 76: databases in recent years on the is
Page 77 and 78: and are able to cross the initial b
Page 79 and 80: contrary to current received wisdom
Page 81 and 82: - Height and weight for age an impo
Page 83 and 84: eliable and regular immunisation, m
Page 85 and 86: Table 27: Utilisation of health rel
Page 87 and 88:
Aanganwadi worker irregular +++ +++
Page 89 and 90:
impedes retention in school is the
Page 91 and 92:
for both. Enhancing access without
Page 93 and 94:
SECTION FOUR: POLICY IMPLICATIONS A
Page 95 and 96:
o While in-service teacher training
Page 97 and 98:
Balwadis of Pratham (Mumbai, Delhi
Page 99 and 100:
and monitoring, poor cold chain mai
Page 101 and 102:
BIBLIOGRAPHY AND REFRENCES 1. Aggar
Page 103:
47. Sundaram, K. 2001. ‘Employmen
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