As the wave of the Covid-19 pandemic grips the globe, the entire population of affected countries has been left vulnerable. Especially worrisome has been the long-term impact that such a crisis can have on children in the coming days and years. Though medically, it has been observed that children have been less affected by the deadly virus, concerns of them being the “hidden victims” of this global health emergency cannot be overlooked.
There is no doubt that ensuring a healthy life for children needs a holistic approach amid this pandemic. This entails not just tackling the immediate threat of the virus on children but also looking at the long-term effects of this crisis on children’s nutrition, health and overall well-being. These concerns have also found voice in the UN agenda for action brought out earlier in April this year, to tackle this “health crisis from becoming child rights crisis”.
With the nationwide lockdown in place since March 24 (Unlock 1.0 for the grown-up), the undivided focus of both the Union and State Governments’ machinery has been on attending to the immediate medical needs for Covid-19. The apprehension is that the crucial services like providing immunisation, regular health check-ups and supplementary nutrition to children, pregnant women and nursing mothers through programmes like the Integrated Child Development Services (ICDS) have taken a backseat in different parts of the country. These can have negative effects on the long-term health of children, far beyond the comprehensibility of the lockdown phase. Globally, there is evidence to show that during the 2014 Ebola outbreak in West Africa, reduced access to treatments led to huge rise in the number of fatalities among children due to malaria, HIV/AIDS and tuberculosis. Closer home, encephalitis in Bihar’s Muzaffarpur, in the midst of the lockdown, with conspicuous shortfall in paediatric ICUs is a point of grave concern.
How is India placed on the nutrition front?
In terms of numbers, India’s health and nutrition related indicators paint a far from rosy picture. With 35 per cent of children being stunted, 17 per cent being wasted, 33 per cent being underweight and almost 40 per cent of adolescent girls being anaemic (Comprehensive National Nutrition Survey, 2016-18), the need for sustained and focused Government interventions to reduce these numbers cannot be stressed enough. India’s position in the Global Hunger Index stood at 102nd in 2019, out of a total of 117 countries. It is not surprising then that, only about 6 per cent of all children between 6 and 23 months in India are able to get a minimum acceptable diet. Needless to say, children and women from marginalised communities, migrant worker families, tribal population, etc, are disproportionately disadvantaged in this regard. The 15th Finance Commission, taking cognizance of the situation, has recommended, in its 2020-21 report, a grant of Rs 7,735 crore be transferred to States for the year 2020-21, with its first instalment released from the Centre by May 2020.
The pandemic has overstretched an already strained health infrastructure, with huge pre-existing human resource shortages, far beyond its capacity. The networks of community health workers like those associated with the Anganwadis (under ICDS), Accredited Social Health Activists or ASHAs (under National Rural Health Mission) and others are understaffed and overburdened as they juggle between their conventional duties of looking after the well-being of children and mothers and their new found roles as Covid warriors.
These raise grave concerns regarding delivery of crucial services like antenatal and postnatal care, vaccinations, routine check-ups, provision of nutritious food, etc, which can leave intergenerational footprints on the health of children.
The immediate loss of income and employment, due to the lockdown-induced crisis, has caused many rural families to reduce their dietary intake, reports a study of 12 States undertaken by a consortium of civil society organisations. The effect of such severe living conditions on the nutrition of pregnant women and children can hardly be fathomed. Moreover, the stringent restrictions of the lockdown have left limited scope for Government interventions like Anganwadi care and provision of hot cooked food in schools. The Central Government’s directive to supply dry rations or cooked food to the 11.6 crore children beneficiaries across the country under the Midday Meal scheme is fraught with implementation challenges in different States. Even in States that have taken proactive stance in this regard, delivering supplies to remote corners of the States have proved to be a major challenge for the Anganwadi workers who have been extensively involved in this mammoth task. In such a situation, there is an urgent need for sustained Government support to these vulnerable families. Further, a quick adaptation of the new modalities of functioning for these Government run programmes is vital for reaching out to the most vulnerable women and children, solely dependent such Government support.
What lies ahead
There is an anticipation that resources earmarked for these programmes, as for many other social sector schemes, might be diverted for tackling the immediate health crisis and these could see substantial decline in the supplementary budgets that the Union Government is expected to announce soon. Needless to say, even as the Union and the State Governments seek out extra funds by drawing upon resources from various sources, curtailing funds from crucial health and nutrition related schemes can prove to have disastrous outcomes, especially for children. Regular and persistent efforts towards fighting several non-Covid diseases like malaria, diarrhoea, encephalitis, etc, which critically affect children with low immunity levels are bound to receive a major blow if there are shortages of funds.
The need of the hour, therefore, is to at least protect, if not enhance, the budgets for both the crucial nutrition related service delivery programmes like Anganwadi Services, Midday Meal, POSHAN Abhiyan, etc, and the conditional cash transfer interventions like Pradhan Mantri Matru Vandana Yojana and others. Further, the Union Government can also consider relaxing some of the eligibility norms of these schemes to extend the benefits to many more. While focusing on the battle against Covid, we must not lose sight of our long-standing fight against under-nutrition and hunger. A multi-sectoral concerted approach towards nutrition at early stages of life, as endorsed in the MOSPI 2018 report, has become an undeniable imperative, more so than ever, to provide a fighting chance to our children in the long battle against not just this present pandemic but for future crises as well.
(The writer is associated with the Centre for Budget and Governance Accountability)
