Saturday, January 23, 2016

[Editorial # 48] The unmet health challenge : The Hindu

[Following editorial has been published in The Hindu on 23rd January 2016. Read through it and try to answer the questions that follow. Please do not copy and paste answers. The objective of this exercise is to get you in the groove of answer -writing. Try to write in your own words. Don't hesitate to write in a bulleted-format, if you are uncomfortable in writing in paragraph form.]

The first set of data from the National Family Health Survey-4 for 13 States and two Union Territories should be seen as a report card on how effectively India has used its newly created wealth to alter a dismal record of nutritional deprivation, ill-health and lost potential among its citizens, particularly women and children. Given the steady growth in real per capita GDP since the 1980s, and the progress made since Independence in overcoming severe undernourishment, enlightened policy approaches could have brought about a giant leap from 1992-93, when the first NFHS was conducted, ensuring that no child or woman was left behind in the quest for health for all. Evidently, the Indian state has not viewed the situation — even at the height of a prosperous phase of economic growth a decade ago — of 39 per cent of children under the age of five remaining underweight as constituting a national crisis. It comes as no surprise, therefore, that this failure to assume responsibility for child nutrition has left 34 per cent of children in that age group underweight today. There is also a lot of evidence to show that the deprived sections of India’s children have low weight even at birth due to the general neglect of women’s nutrition and well-being.

It is imperative that the data coming out of NFHS-4 lead to the charting of a new policy course that makes access to nutrition and health a right for all. Asserting this right would require the strengthening of the Integrated Child Development Services scheme in all States, particularly those with a higher proportion of underweight and stunted children. In the first set of data, Bihar and Madhya Pradesh bring up the rear on these crucial metrics of child development. It deserves mention that even within the ICDS, there is a clear deficit in caring for the needs of children under three. Nutrition in the first two or three years of a child’s life has a lasting impact on her development; care given in later years, including freshly cooked meals at school, cannot undo the setback caused by neglect during this foundational phase. Other key areas requiring intervention are access to antenatal care, reduction of high levels of anaemia among women, and immunisation; it is a cause for concern that a State such as Tamil Nadu with an active public health system recorded a reduced rate of full child immunisation compared with NFHS-3 data. Overall, there is a need to assess the health of citizens more frequently than the current NFHS cycle of seven to 10 years allows. Data gathered every two or three years would help make timely policy corrections. A fuller picture of the health of urban and rural Indians will emerge later in the year when data for all States become available. They should send out the message that sustained economic growth is not possible without state support to achieve the well-being of the population, especially women and children.

Questions:

1. Explain the following terms (50 words)
  • Antenatal care
  • Anaemia
  • Immunisation
  • Stunting (in context of child's health)
  • Wasting (in context of child's health)


2. What is a survey? What is its purpose? Give examples

3. What is National Family Health Survey-4? Who conducts this survey? What is the frequency of conducting NFHS? 

4. What is the objective of conducting NFHS? 

5. What are the findings of NFHS 4? 

6. What are similar such surveys conducted in India? 

7. What is understood by Real Per Capita GDP? How is it different from Nominal Per Capita GDP? Illustrate with examples

8. What percentage of under-five children are underweight in India and World? What are the reasons for the same?

9. What are the important features of ICDS program? Which agency/authority is responsible for its implementation? What are various issues being faced during the implementation of ICDS?

10. Why is nutrition provided to children during first couple of years of their growth more important than later years?

11. An effective policy formulation mechanism depends a lot on the accuracy of data collected. Do you agree? Discuss (200 words)

12. "Sustained economic growth is not possible without state support to achieve the well-being of the population, especially women and children." Analyse (200 words)

16 comments:

  1. Antenatal care:
    The care taken by the mothers during pregnancy is called antenatal care.It needs proper diet and regular doctor check ups.
    Anaemia: It is a condition in the human body when the number of RBC in the blood is below normal.
    IMMUNISATION: It is a process by which the body is fortified to immunogens which causes diseases.
    Stunting :- inadequate height for age.

    ReplyDelete
  2. FACTS: UNICEF
    morethan 1/3 of world's children who are wasted lives in india
    india accounts for morethan 3 out of every 10 stunted children in the world
    cutoff for mother being undernourished is : BMI = 18.5
    of total children who are <5years: 43% underweight and 48% stunted.
    (mother edu ) = 5X(mother not edu) : % of children who are severely underweight
    per year 74L low birth weight babies are getting added: india is first
    only 1/3 of children receive anganwadi support
    only 1/4 receive supplement food from ICDS
    70% of chilreen aged 6-59 months are aneamic.

    ReplyDelete
    Replies
    1. 43 crores indians are aged <18
      12cr indians aged <5

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    2. neonatal period (0-27 days of life).

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  3. Wasting (in context of child's health):
    Under-weight is defined as low weight to age. This is the broadest definition of malnutrition, and is the one adopted by Govt. of India under ICDS. Under-weight may be caused either due to low height to age (stunting), or low weight to height (wasting), or a combination of both.

    ReplyDelete
  4. 2. What is a survey? What is its purpose? Give examples
    A.survey is the detailed study of mkt or geographic area to collect data on the impressions, attitudes, opinions , satisfaction level by polling a section of society.
    It ensures that the survey represents people from all walks of life to make data reflect the ground scenario
    ex:-NHFS

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  5. 3. What is National Family Health Survey-4? Who conducts this survey? What is the frequency of conducting NFHS?
    A. The Ministry of Health and Family Welfare designated the International Institute for Population Sciences(IIPS) to conduct the survey for every 10 years. the first being in 1992-93 and the earlier one during 2005-06. its obective is to provide the
    fertility rates
    infant and child mortality
    the practice of family planning,
    maternal and child health,
    reproductive health,
    nutrition,
    anaemia,
    utilization and quality of health and family planning service

    ReplyDelete
  6. 5. What are the findings of NFHS 4?
    A. The NFHS-4 is conducted in 11 states and 7 UTs.
    women literacy gone up by 12.5%
    sex ratio declined in all states except in uttarakhand and meghalaya. on avg 985/1000.
    child marriages reduced by 14% in females and 7% in males
    more than 50% of popu have access to sanitation except bihar and MP

    ReplyDelete
  7. 6. What are similar such surveys conducted in India?
    .
    Unorganised Service Sector survey
    India - Domestic Tourism survey

    Survey on Unincorporated Non-agricultural Enterprises (Excluding Construction)
    Employment and Unemployment
    Household Consumer Expenditure

    ReplyDelete
    Replies
    1. all above are sample surveys unlike population census, socio-eco caste census where every individual is accounted.

      Delete
  8. 7. What is understood by Real Per Capita GDP? How is it different from Nominal Per Capita GDP? Illustrate with examples
    A.GDP represents the value of goods and services produced in a country. Real per-capita GDP takes inflation into consideraton while the nominal GDP per capita takes face value.

    ReplyDelete
  9. 9. What are the important features of ICDS program? Which agency/authority is responsible for its implementation? What are various issues being faced during the implementation of ICDS?
    aims at providing services to pre-school children in an integrated manner so as to ensure proper growth and development of children in rural, tribal and slum areas
    features:
    improve the nutritional and health status of children in the age group of 0-6 years.
    lay the foundation for proper psychological, physical and social development of the child.
    reduce the incidence of mortality, morbidity, malnutrition and school dropout
    achieve effective co-ordination of policy and implementation amongst the various departments to promote child development,
    enhance the capability of the mother to look after the normal health and nutritional needs of the child through proper nutrition and health education.
    women and child dept is responsible for implementation of the scheme.

    ReplyDelete
  10. 10. Why is nutrition provided to children during first couple of years of their growth more important than later years?
    A.COLOSTRUM, or “first milk”, is rich in protective factors. Hence the mothers are adviced to start feeding the child in first 2 hours.
    breastfeeding for 2 years will provide the best nutrition to the child.
    The protein in breast milk is much easier to digest than the protein in cow’s milk or formula, making your baby less likely to suffer from digestive problems such as gassiness, rashes, and colic.

    ReplyDelete
  11. 11. An effective policy formulation mechanism depends a lot on the accuracy of data collected. Do you agree? Discuss (200 words)
    A.Policies are generally made when the new challenges emerges. The data gathered by the various agencies with huge variations in metrics provides information which has to be analysed and conclusions have to be drawn. However, with the lack of unified standards while collecting the data gives diverse results in the studies.
    for instance the BPL figures of different committies like tendulkar committee, saxena committee due to lack of standard methodology.
    the more the figures are accurate in their numbers the more will galvanize the real ground reality. Hence budget allocations will be made more targetted without compromising the efficiency.

    ReplyDelete
  12. 12. "Sustained economic growth is not possible without state support to achieve the well-being of the population, especially women and children." Analyse (200 words)
    A.The well-being of the entire population is very important especially when the counrty is on its way to take-off in terms of development.Since women and children are more vulnerable sections utmost care is needed for their footage in process of growth and development.
    WOMEN:
    recent reports states that the to tap the full benefits of development , gender equality is very much essential providing equal platform for both men and women.
    WOMEN:
    in rural areas since the households are mainly managed by the women , the entire household is under the influence of the decisions of the women. Hence, women empowerment leads to rural empoweremnt as 70% popu lives in villages.
    CHILDREN:-
    india has a population of 28crore children living in rural of age 0-14 years while just 8 crores in urban cities.proper antenatal and postnatal care to the mother and child to tackle the issues anaemia, malnutrition, stunting or wasting which are the major challenges in india has to be dealt with utmost care. All these diseases reduce the performance of the child over the years where reasoning and logical skills will be poor.This reduces the overall societal progress when compared to the globalised world.
    the recent report on health states that india health sector contributes to the loss of 3% of GDP. Hence proper meauses have to be taken w.r.to W&C development to ensure the economic growth of india.

    ReplyDelete
  13. Childhood stunting is a condition that is defined as height for age below the fifth percentile on a reference growth curve.

    ReplyDelete