Human Development in India - NCAER

8Child Well-beingThe well-being of children is one of the most importantmarkers of development for any nation and has formed anintegral part of all discussions about human development.As India experiences record economic growth rates, it is fairto ask whether the advantages of economic growth reach thisvulnerable section of society. Children face different risksat different ages. Young children need a chance to grow uphealthy and strong through the risky years of infancy andearly childhood. Children who survive these risks past agefive need an opportunity to feed their minds in a nurturingeducational environment and teenagers need an opportunityto prepare themselves for adult roles, without being thrustinto premature responsibilities. This chapter assesses howwell India has done by her most vulnerable citizens in providingthese opportunities. Although education and healthhave received considerable attention in Chapters 6 and 7,respectively, this chapter attempts to place some of thesediscussions in the context of broader societal patterns byfocusing on two dimensions of child well-being, child healthand survival, and labour force participation.INFANT AND CHILD SURVIVALWhile sweeping epidemics and widespread famines seem tobe a thing of the past, young children still face substantial risksin the first five years of life. Many sources of data, includingthe Sample Registration System as well as the three wavesof the NFHS, document substantial declines in infant andchild mortality. For example, the NFHS recorded a declinein the infant mortality rate (that is, the number of childrendying before completing the first year of life) from 79 per1,000 births in 1992–3 to 57 per 1,000 births in 2005–6. Inspite of this impressive decline, the NFHS recorded that oneout of 14 children die before reaching age five, and the IHDSrecords an infant mortality rate of 52 per 1,000 births.Although levels of infant and child mortality areimportant, as we think about policies to address this, it is theage pattern of mortality that deserves the greatest attention.Death in the first month of life, called neonatal mortality, isfrequently associated with gestational and delivery problems,genetic factors, premature birth, or a complicated delivery.Post-neonatal deaths (that is, death in the second throughtwelfth months of life) may be somewhat influenced bylow birth weight or delivery related factors, but the role ofenvironmental factors in post-neonatal deaths becomes farmore important. Infant deaths in this age range are oftendue to respiratory illnesses as well as poor nutrition. Amongchildren who survive to be one-year old, between age oneand five, most of the deaths are due to environmentalcauses, which include diarrhoea and other gastrointestinaldiseases, respiratory illness and other contagious diseases,and accidents.Figure 8.1 indicates the distribution of deaths amongchildren under five in the IHDS.In calculating these figures, we focused on all live birthsoccurring in the ten-year period preceding the survey. 1 Figure8.1 indicates that a majority of deaths occur to newborn1In surveys with larger samples, such as the NFHS, it is common to focus on births in the preceding three years. Given the sample size limitations in theIHDS, however, we focused on births in the preceding ten years. While the number of births covered by IHDS is quite large, 38,259 births in the precedingten years, the number of deaths is much smaller at 2,373 reducing the precision of the estimate. Hence, results presented here should be treated withcaution.