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fuzzy. Learning outcomes are integral to the validity of completion of primary schooling as a
proxy indicator of holistic child development. Further, the ‘free’ aspect of primary schooling too
requires constant interrogation as indirect costs continue to expand – be it in nature of voluntary
contributions, purchasing guidebooks etc. Despite evidence of universal primary enrolment, a
holistic approach to child development constantly needs to tackle the cumulative nature of social,
political, and economic exclusion that frames the lives of poor children. One should not, thus, be
surprised by the ambivalence expressed towards the value of education in poor households.
Health and nutrition:
The irony is that a similar engagement (including ambiguity) is missing when discussing health
and nutrition. There is a sense of resignation – not only in families but also among health (ANM)
and nutrition (AWW) service providers. The medical expert associated with the study, Dr. Ranga
Rao, explained that the relation between health and education is often perceived as a one-way
street, with most discussions focusing on the role education can play in facilitating health
awareness and improving the health status of individuals and communities. Usually left out of the
debate is the critical and reciprocal nature of link between health and education, specifically in
relation to children, whereby poor health and nutrition can actually prove to be a barrier to
attendance and educational attainment/achievement. The most obvious medical evidence
indicates that childhood disability, chronic illness, and extreme malnutrition of children is a direct
impediment to his/her enrolment in school. Further, the level of frequency, duration and severity
of illness that affects a child also influences the regularity and attendance of an enrolled child.
However, barring the polio drive, there is little energy in the health sector.
Box 17: Synergy between health, nutrition and education
Recent surveys of research constitute strong evidence that the synergy among health, nutrition
and education becomes important not only from the overall development perspective but also
from the point of view of success in schooling (Levinger 1992, Myers 1992, Pollitt 1990, Kaul
2000 ). This synergy positively or negatively contributes to the development of the child at each
stage, i.e., from year 0 (conception) to 11. It is commonly recognized that a good foundation,
from the early years, is critical for the development of the child’s active learning capacity. The
capacities for processing, structuring and classifying information, the ability to ask and answer
appropriate questions, short-term memory and the levels of alertness, attention and concentration
are all influenced by what happens to the child at each stage between 0–11 years and what s/he
experiences from the point of view of health, nutrition, psychosocial support, etc. Better health
and nutrition are positively associated with gains in schooling in many areas—enrolment at
younger ages, lesser grade repetition, lesser absenteeism, higher-grade completion and better test
scores. Most of these studies are based on socio-economic survey data that provides information
Educational Resource Unit Page 65 April 2003