Child development in India

Every parent wants their children to grow up healthy.

Child development in India is the Indian experience of biological, psychological, and emotional changes which children experience as they grow into adults. Child development has a significant influence on personal health and, at a national level, the health of people in India.

Children constitute a significant part of the national disease burden of India.[1] Environmental health problems such as Pollution-related diseases, challenges with a water supply, and sanitation in India are difficult to fix and greatly affect children.[1] Many children in India miss vaccination and consequently acquire infectious diseases that vaccines could have prevented.

40% of children in India experience malnutrition or stunted growth due to lack of access to healthy meals.[2] India has a success story in the Midday Meal Scheme, which feeds 100 million children daily.

Early childhood development

Early childhood is the period up to the age of six.[3] Other definitions extend ECD to age eight to account for changes that occur during a child's transition into primary level education.[4] Children can suffer brain damage in the absence of healthy conditions.[5][6]

Child development markers

Common markers used by researchers and experts in the statistical examination of childhood development include, age, income, and locality. This show marked differences in the India context.

Age

First 1000 days

The first 1000 days is a concept in child development, that recommends planning to give a child the best possible start in their first 1000 days after birth.[7] The general recommendation for babies is that they should breastfeed soon after birth to get colostrum.[7] Some factors which prevent mothers from giving colostrum to their newborns include maternal health challenges, including the risk of maternal mortality and social taboo.[7]

After a child is born, regular access to primary care from a doctor improves health outcomes.[8] Young children visiting a doctor get vaccinated.[8] Children in families that are much poor are less likely to access the care they need.[8]

Pre-adolescence

Preadolescence is the period where early childhood ends, and puberty begins. Girls at this time need education and preparedness to do menstrual hygiene management.[9] A 2020 study reported that half of the girls in India get their first information about menstruation after their first period.[9] Girls who are prepared for this have better development outcomes.[9]

Optimal child development starts before conception and is dependent on adequate nutrition for mother and child, protection from threats, provision of learning opportunities, and caregiver interactions that are stimulating, responsive, and emotionally supportive.[10] The first 1000 days are considered crucial because of the adaptability of children's brains during this period and because reversing early deficits becomes more difficult as children grow older.[11]

Optimal development in early childhood can be disrupted by various adversities concerning a child's environments and relationships with caregivers. These adversities vary in intensity and range from violence in the home, neglect, abuse, lack of opportunity for play and cognitive stimulation, and parental ill-health.[12][13] Exposure to multiple adversities poses a cumulative detrimental burden to a child's wellbeing, especially in low- and middle-income communities.[14][15]

In 2008, there were an estimated 158 million children under the age of six in India. Generally, these children suffered from poor nutrition and healthcare.[16] Around one in ten Indian children suffered from diarrhoea and almost one in six suffered from fever. Half of the under-threes were deprived of full immunisation.[17]

Inequalities in child health and development

Childhood development is considered a key factor in achieving the ambitious global Sustainable Development Goals.[18] 45% of Indian under-threes experience stunting, a measure of chronic malnutrition.[19]

Prevalent factors in child underdevelopment

Nutrition

A 2017 study reported that 57% of newborns in their first 1000 days in India transition on time from breastfeeding to nutritious solid food; 48% get their meals frequently enough; 33% have enough food variety for nutrition, and 21% get overall adequate meals.[20]

India's Midday Meal Scheme has been a major success for school-age children, which provides a daily hot healthy meal to 100 million children.[21] Current trends in the program are adapting the meals based on research to meet more specific nutrition needs.[21]

Since the 1970s, India has had programs to prevent vitamin A deficiency, but this problem is much less nowadays.[22][23] Vitamin D deficiency is a challenge that the government is addressing with food fortification.[24]

Poverty

Children in poverty experience health problems which children in families with more money will not have. In general, any sort of health problem is worse for someone without immediate access to healthcare. Medical problems which have poverty as a cause include issues in oral health.[25] Kerala organized poverty reduction programs and, after that, had better children's health.[2] Various commentators have examined the Kerala model as an example of what might work elsewhere in India.[2]

Environmental health

Children in India are significantly affected by environmental health problems.[1] Challenges such as air pollution, water pollution, health effects of pesticides, and sanitation require government-level planning to fix and are challenging to address.[1]

Urbanisation in India has been increasing more quickly than many cities can develop.[26] There is a great disparity in access to healthcare within cities, depending on the money a person has.[26]

Vaccination

Of all countries, India has the highest number of deaths of children under age five.[27] Most of these deaths are from vaccine-preventable diseases.[27] If children in India got vaccines, then their health and lives would be improved.[27]

Ideally, all children would get their vaccinations on time. The BCG vaccine against tuberculosis and leprosy 31% of children get it on time, and 87% get it by age 5.[27] For DPT vaccine against diphtheria, pertussis, and tetanus, 19% get it on time and 63% by age 5.[27] For the meningococcal vaccine against meningococcal disease, 34% get it on time, and 76% get it by age 5.[27]

Children in slums more often lack vaccine protection.[28]

Other societal issues

Various difficult and social issues are related to child development in India. Poverty presents particular challenges for street children in India,[29] child workers in India,[30] and children trafficked in India.[31] Children's health matters related to gender include gender inequality in India,[32] female infanticide in India,[33] and certain aspects of child marriage in India.[34]

Regional variation

A 2012 nutrition study in Maharashtra found that household and family access to food was less of a problem, but having a variety of nutritious food was a challenge to address.[35]

A report on Haryana recommended access to cleaner-burning fuel to improve children's health through improved household aid quality.[36]

Society and culture

A 2017 study reported that India's government has policy and delivery systems that are favorable for achieving improvements in child nutrition.[37] The challenges are financing such social programs, researching to keep them on track, and urban capacity to grow programs.[37]

Private sector impact

The efforts of several privately funded organizations, including the Aga Khan Foundation, have positively impacted ECD in India.[38]

References

  1. 1 2 3 4 Thimmadasiah, N Bangalore; Joshi, TK (13 January 2020). "India: country report on children's environmental health". Reviews on Environmental Health. 35 (1): 27–39. doi:10.1515/reveh-2019-0073. PMID 31926103. S2CID 210158493.
  2. 1 2 3 Pappachan, B; Choonara, I (2017). "Inequalities in child health in India". BMJ Paediatrics Open. 1 (1): e000054. doi:10.1136/bmjpo-2017-000054. PMC 5862182. PMID 29637107.
  3. ↑ Starting Strong. "Early Childhood Development in India – Guide for funders and charities" (PDF). New Philanthropy Capital.
  4. ↑ World Health Organization (2020). Improving Early Childhood Development: WHO guideline (PDF). Geneva, Switzerland: World Health Organization. p. 1. Retrieved 21 October 2020.
  5. ↑ Garcia, Marito H.; Pence, Alan; Evans, Judith, eds. (22 January 2008). Africa's Future, Africa's Challenge. doi:10.1596/978-0-8213-6886-2. ISBN 978-0-8213-6886-2.
  6. ↑ Center on the Developing Child at Harvard University (2016). From Best Practices to Breakthrough Impacts: A Science-Based Approach to Building a More Promising Future for Young Children and Families (PDF). Cambridge (MA): Harvard University. p. 15. Retrieved 21 October 2020.
  7. 1 2 3 Chellaiyan, VG; Liaquathali, F; Marudupandiyan, J (2020). "Healthy nutrition for a healthy child: A review on infant feeding in India". Journal of Family & Community Medicine. 27 (1): 1–7. doi:10.4103/jfcm.JFCM_5_19 (inactive 31 October 2021). PMC 6984033. PMID 32030072.{{cite journal}}: CS1 maint: DOI inactive as of October 2021 (link)
  8. 1 2 3 Zuhair, Mohd; Roy, Ram Babu (14 December 2017). "Socioeconomic Determinants of the Utilization of Antenatal Care and Child Vaccination in India". Asia-Pacific Journal of Public Health. 29 (8): 649–659. doi:10.1177/1010539517747071. PMID 29237280. S2CID 20590408.
  9. 1 2 3 Sharma, S; Mehra, D; Brusselaers, N; Mehra, S (19 January 2020). "Menstrual Hygiene Preparedness Among Schools in India: A Systematic Review and Meta-Analysis of System-and Policy-Level Actions". International Journal of Environmental Research and Public Health. 17 (2): 647. doi:10.3390/ijerph17020647. PMC 7013590. PMID 31963862.
  10. ↑ "WHO | Nurturing care for early childhood development: Linking survive and thrive to transform health and human potential". WHO. Archived from the original on 20 September 2017. Retrieved 11 June 2020.
  11. ↑ National Research Council (US) Institute of Medicine (US) Committee on Integrating the Science of Early Childhood Development; Shonkoff, J. P.; Phillips, D. A. (13 November 2000). From Neurons to Neighborhoods. doi:10.17226/9824. ISBN 978-0-309-06988-5. PMID 25077268.
  12. ↑ Cronholm, Peter F.; Forke, Christine M.; Wade, Roy; Bair-Merritt, Megan H.; Davis, Martha; Harkins-Schwarz, Mary; Pachter, Lee M.; Fein, Joel A. (September 2015). "Adverse Childhood Experiences". American Journal of Preventive Medicine. 49 (3): 354–361. doi:10.1016/j.amepre.2015.02.001. ISSN 0749-3797. PMID 26296440.
  13. ↑ Walker, Susan P; Wachs, Theodore D; Meeks Gardner, Julie; Lozoff, Betsy; Wasserman, Gail A; Pollitt, Ernesto; Carter, Julie A (January 2007). "Child development: risk factors for adverse outcomes in developing countries". The Lancet. 369 (9556): 145–157. doi:10.1016/s0140-6736(07)60076-2. ISSN 0140-6736. PMID 17223478. S2CID 11120228.
  14. ↑ Walker, Susan P; Wachs, Theodore D; Grantham-McGregor, Sally; Black, Maureen M; Nelson, Charles A; Huffman, Sandra L; Baker-Henningham, Helen; Chang, Susan M; Hamadani, Jena D; Lozoff, Betsy; Gardner, Julie M Meeks (October 2011). "Inequality in early childhood: risk and protective factors for early child development". The Lancet. 378 (9799): 1325–1338. doi:10.1016/s0140-6736(11)60555-2. ISSN 0140-6736. PMID 21944375. S2CID 14964512.
  15. ↑ Wachs, Theodore D.; Rahman, Atif (15 January 2013), "The Nature and Impact of Risk and Protective Influences on Children's Development in Low-Income Countries", Handbook of Early Childhood Development Research and Its Impact on Global Policy, Oxford University Press, pp. 85–122, doi:10.1093/acprof:oso/9780199922994.003.0005, ISBN 978-0-19-992299-4
  16. ↑ "Foreword", The State of the World's Children 2008, State of the World's Children, UN, p. 3, 31 December 2008, doi:10.18356/c8d42ffb-en, ISBN 978-92-1-059754-8
  17. ↑ Vart, Priya; Jaglan, Ajay; Shafique, Kashif (5 June 2015). "Caste-based social inequalities and childhood anemia in India: results from the National Family Health Survey (NFHS) 2005–2006". BMC Public Health. 15 (1): 537. doi:10.1186/s12889-015-1881-4. ISSN 1471-2458. PMC 4456806. PMID 26044618. S2CID 18616090.
  18. ↑ Daelmans, Bernadette; Darmstadt, Gary L; Lombardi, Joan; Black, Maureen M; Britto, Pia R; Lye, Stephen; Dua, Tarun; Bhutta, Zulfiqar A; Richter, Linda M (January 2017). "Early childhood development: the foundation of sustainable development". The Lancet. 389 (10064): 9–11. doi:10.1016/s0140-6736(16)31659-2. ISSN 0140-6736. PMID 27717607. S2CID 205983467.
  19. ↑ Vart, Priya; Jaglan, Ajay; Shafique, Kashif (5 June 2015). "Caste-based social inequalities and childhood anemia in India: results from the National Family Health Survey (NFHS) 2005–2006". BMC Public Health. 15 (1): 537. doi:10.1186/s12889-015-1881-4. ISSN 1471-2458. PMC 4456806. PMID 26044618. S2CID 18616090.
  20. ↑ Aguayo, Víctor M. (October 2017). "Complementary feeding practices for infants and young children in South Asia. A review of evidence for action post-2015". Maternal & Child Nutrition. 13: e12439. doi:10.1111/mcn.12439. PMC 6865921. PMID 29032627.
  21. 1 2 Ramachandran, P (June 2019). "School Mid-day Meal Programme in India: Past, Present, and Future". Indian Journal of Pediatrics. 86 (6): 542–547. doi:10.1007/s12098-018-02845-9. PMID 30637675. S2CID 58541996.
  22. ↑ Greiner, Ted; Mason, John; Benn, Christine Stabell; Sachdev, H. P. S. (14 January 2019). "Does India Need a Universal High-Dose Vitamin A Supplementation Program?". The Indian Journal of Pediatrics. 86 (6): 538–541. doi:10.1007/s12098-018-02851-x. PMID 30644040. S2CID 58654408.
  23. ↑ Awasthi, S; Peto, R; Read, S; Clark, S; Pande, V; Bundy, D; DEVTA (Deworming and Enhanced Vitamin A), team. (27 April 2013). "Vitamin A supplementation every 6 months with retinol in 1 million pre-school children in north India: DEVTA, a cluster-randomised trial". Lancet. 381 (9876): 1469–77. doi:10.1016/S0140-6736(12)62125-4. PMC 3647148. PMID 23498849.
  24. ↑ G, R; Gupta, A (2015). "Fortification of foods with vitamin D in India: strategies targeted at children". Journal of the American College of Nutrition. 34 (3): 263–72. doi:10.1080/07315724.2014.924450. PMID 25790322. S2CID 52804739.
  25. ↑ Peres, MA; Macpherson, LMD; Weyant, RJ; Daly, B; Venturelli, R; Mathur, MR; Listl, S; Celeste, RK; Guarnizo-Herreño, CC; Kearns, C; Benzian, H; Allison, P; Watt, RG (20 July 2019). "Oral diseases: a global public health challenge" (PDF). Lancet. 394 (10194): 249–260. doi:10.1016/S0140-6736(19)31146-8. PMID 31327369. S2CID 197604973.
  26. 1 2 Sharma, J; Osrin, D; Patil, B; Neogi, SB; Chauhan, M; Khanna, R; Kumar, R; Paul, VK; Zodpey, S (December 2016). "Newborn healthcare in urban India". Journal of Perinatology. 36 (s3): S24–S31. doi:10.1038/jp.2016.187. PMC 5144125. PMID 27924107.
  27. 1 2 3 4 5 6 Shrivastwa, Nijika; Gillespie, Brenda W.; Lepkowski, James M.; Boulton, Matthew L. (September 2016). "Vaccination Timeliness in Children Under India's Universal Immunization Program". The Pediatric Infectious Disease Journal. 35 (9): 955–960. doi:10.1097/INF.0000000000001223. PMID 27195601. S2CID 4585001.
  28. ↑ Singh, S; Sahu, D; Agrawal, A; Vashi, MD (July 2018). "Ensuring childhood vaccination among slums dwellers under the National Immunization Program in India – Challenges and opportunities". Preventive Medicine. 112: 54–60. doi:10.1016/j.ypmed.2018.04.002. PMID 29626558. S2CID 4879865.
  29. ↑ Nigam, S (1994). "Street children of India – a glimpse". Journal of Health Management. 7 (1): 63–7. PMID 12289892.
  30. ↑ Srivastava, Rajendra N. (28 August 2019). "Children at Work, Child Labor and Modern Slavery in India: An Overview". Indian Pediatrics. 56 (8): 633–638. doi:10.1007/s13312-019-1584-5. PMID 31477640. S2CID 201751620.
  31. ↑ Dhawan, J; Gupta, S; Kumar, B (2010). "Sexually transmitted diseases in children in India". Indian Journal of Dermatology, Venereology and Leprology. 76 (5): 489–93. doi:10.4103/0378-6323.69056. PMID 20826987.
  32. ↑ Subramanian, Samyukta (15 October 2019). "India's policy on early childhood education". Brookings Institution.
  33. ↑ Sahni, M; Verma, N; Narula, D; Varghese, RM; Sreenivas, V; Puliyel, JM (21 May 2008). "Missing girls in India: infanticide, feticide and made-to-order pregnancies? Insights from hospital-based sex-ratio-at-birth over the last century". PLOS ONE. 3 (5): e2224. Bibcode:2008PLoSO...3.2224S. doi:10.1371/journal.pone.0002224. PMC 2377330. PMID 18493614.
  34. ↑ Nour, NM (2009). "Child marriage: a silent health and human rights issue". Reviews in Obstetrics & Gynecology. 2 (1): 51–6. PMC 2672998. PMID 19399295.
  35. ↑ Chandrasekhar, S.; Aguayo, Víctor M.; Krishna, Vandana; Nair, Rajlakshmi (October 2017). "Household food insecurity and children's dietary diversity and nutrition in India. Evidence from the comprehensive nutrition survey in Maharashtra". Maternal & Child Nutrition. 13: e12447. doi:10.1111/mcn.12447. PMC 6866156. PMID 29032621.
  36. ↑ Pillarisetti, A; Jamison, DT; Smith, KR; Mock, CN; Nugent, R; Kobusingye, O; Smith, KR (27 October 2017). "Household Energy Interventions and Health and Finances in Haryana, India: An Extended Cost-Effectiveness Analysis". Disease Control Priorities, Third Edition (Volume 7): Injury Prevention and Environmental Health. pp. 223–237. doi:10.1596/978-1-4648-0522-6_ch12. ISBN 978-1-4648-0522-6. PMID 30212113.
  37. 1 2 Avula, Rasmi; Oddo, Vanessa M.; Kadiyala, Suneetha; Menon, Purnima (October 2017). "Scaling-up interventions to improve infant and young child feeding in India: What will it take?". Maternal & Child Nutrition. 13: e12414. doi:10.1111/mcn.12414. PMC 6866129. PMID 29032618. S2CID 20148659.
  38. ↑ "Early Childhood Development in India | Aga Khan Development Network". akdn.org. Retrieved 11 June 2020.
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