State of the Young Child in India This Report is one of the first comprehensive studies on young children in India. It focuses on children under 6 years of age and presents key aspects of their well-being and development. With the highest number of neonatal, infant and under-5 deaths in the world, there is an urgent need to address issues that continue to affect the young child in India. This volume: • Introduces two young child indices aggregating selected indicators to separately track child outcomes and child circumstances. • Provides an account of the current situation of the young child in terms of physical and cognitive development, access to care, disadvantaged children and major issues that have led to the continued neglect of this age group. • Explores the policy and legal framework, fiscal space and the role and obligations of key stakeholders, including the state, private sector, civil society, media and the family. • Highlights key recommendations and action points that can help to improve the ecosystem for early childhood care and development. Drawing on specially commissioned technical background papers, supple mented by extensive field experience of Mobile Creches in childcare, this Report will be of interest to practitioners, policymakers and influencers, think tanks and researchers of public policy, development studies, human rights, sociology and social anthropology, as well as general readers. Mobile Creches (MC) is a leading organisation for Early Childhood Development (ECD) in India. Headquartered in New Delhi, it works at the grassroots level for young children under 6 years across the country, with a focus on the most vulnerable – in particular children of migrant families and slum dwellers. It has also developed appropriate training resources to enable a cadre of early childhood care workers across government and non-government settings. As a knowledge organisation, MC presents this Report, which draws upon its decades of working with young children and their families and its engagement with local communities, businesses, practitioners, advocates and policymakers. With the support of State of the Young Child in India Mobile Creches First published 2020 by Routledge 2 Park Square, Milton Park, Abingdon, Oxon OX14 4RN and by Routledge 52 Vanderbilt Avenue, New York, NY 10017 Routledge is an imprint of the Taylor & Francis Group, an informa business © 2020 Mobile Creches The right of Mobile Creches to be identified as author of this work has been asserted by them in accordance with sections 77 and 78 of the Copyright, Designs and Patents Act 1988. The Open Access version of this book, available at www. taylorfrancis.com, has been made available under a Creative Commons Attribution-Non Commercial-No Derivatives 4.0 license. Trademark notice: Product or corporate names may be trademarks or registered trademarks, and are used only for identification and explanation without intent to infringe. British Library Cataloguing-in-Publication Data A catalogue record for this book is available from the British Library Library of Congress Cataloging-in-Publication Data Names: Mobile Creches (Organization : Mumbai, India), corporate author. Title: State of the young child in India / Mobile Creches. Description: 1. | New York : Taylor & Francis Group, 2020. | Includes bibliographical references and index. Identifiers: LCCN 2019056991 (print) | LCCN 2019056992 (ebook) Subjects: LCSH: Children—India—Social conditions—21st century. | Children—India—21st century. | Child development—India. Classification: LCC HQ792.I5 S665 2020 (print) | LCC HQ792.I5 (ebook) | DDC 305.230954—dc23 LC record available at https://lccn.loc.gov/2019056991 LC ebook record available at https://lccn.loc.gov/2019056992 ISBN: 978-0-367-46018-1 (hbk) ISBN: 978-1-003-02648-8 (ebk) Typeset in Sabon by Apex CoVantage, LLC State of the Young Child in India team Core team Anuradha Rajivan, Lead Technical Advisor Sanjay Kaul Sumitra Mishra V. S. Sambandan Samreen Mushtaq Editor Neelam Singh Young Child indices Pronab Sen, Technical Advisor Technical background paper contributors Mridula Bajaj Nandita Chaudhary Ranjana Kesarwani Ranjani Murthy Renu Singh Venkatesan Ramani Vimala Ramachandran Contents List of figures x List of tables xi List of boxes xiv Foreword xvi Acknowledgements xix Acronyms xxi Executive summary xxv 1 The young child in India 1 1.1 Focus on the young child is long overdue 1 1.2 Policy and legal framework have not delivered consistent results 9 1.3 Sustainable development goals pose challenges but also opportunities for India 21 1.4 State is the primary duty bearer to ensure adequate care 22 1.5 A renewed policy focus on the young child is critical 24 2 Advancing physical well-being 30 2.1 Young child mortality 30 2.2 Sex selection and gender discrimination have major implications for the young child 36 2.3 Ill health among young children 38 2.4 Several factors determine child nutrition 43 2.5 Safe water deficit, open defecation and poor hygiene undermine child health 51 2.6 Key issues 52 2.7 Recommendations and action points 64 viii Contents 3 Promoting early childhood learning 79 3.1 Early learning matters 79 3.2 Early childhood education services are crucial for cognitive development 86 3.3 Innovations in ECCE have been notable, many with relevance for policy 91 3.4 Key issues 95 3.5 Recommendations and action points 104 4 Prioritising the disadvantaged child 115 4.1 Children face extreme vulnerability in many ways 115 4.2 Children born in poverty confront multiple deprivations growing up 117 4.3 Socially marginalised communities face specific challenges 124 4.4 Inadequate parental care impedes child development 129 4.5 Key issues 133 4.6 Recommendations and action points 138 5 Childcare and the childcare worker 145 5.1 Nurture and care during early childhood has been under-rated 145 5.2 Home-based childcare is crucial but increasingly challenging 147 5.3 Provision of childcare services is grossly inadequate 153 5.4 Good practices can provide policy pointers and lessons 163 5.5 Key issues 165 5.6 Recommendations and action points 169 6 Fiscal allocations and expenditure for child development 180 6.1 The fiscal experience highlights gaps in public spending 180 6.2 Trends indicate continuing under-allocation 183 6.3 Sub-national trends show variations in management capability and spending 193 6.4 International comparisons show India’s potential untapped 197 Contents ix 6.5 Key issues 197 6.6 Recommendations and action points 200 7 The way forward 207 7.1 Key issues must be addressed 207 7.2 Towards a wholesome childhood for all: major recommendations 212 Annexures 219 Annexure 1: Services provided under the ICDS 221 Annexure 2: Technical note 223 Annexure 3: Sustainable development goals 232 Annexure 4: Extracts from draft national education policy, 2019 245 Annexure 5: List of laws, policies and programmes mentioned in the Report 248 Annexure 6: Statistical tables 250 Annexure 7: Technical background paper contributions 284 Glossary of terms 286 List of contributors 290 Core team members 292 List of participants in roundtable consultation 294 Partners 296 Index 297 Figures 2.1 Child mortality rates from 1992 to 2016 show a steep decline 31 2.2 Trends in immunisation by vaccine, 1992–2016 41 4.1 Percentage of children under age 5 in poorest and richest wealth quintiles in India 118 4.2 Top 10 states by number of women prisoners with children 132 6.1 Budget allocation and expenditure under ICDS Scheme during the Eleventh Plan and the first two years of the XII Plan 191 6.2 Status of Supplementary Nutrition Programme (SNP) in India, 2018 194 6.3 India’s standing with regard to stunting and wasting 198 6.4 China’s standing with regard to stunting and wasting 198 6.5 Bangladesh’s standing with regard to stunting and wasting 198 6.6 Brazil’s standing with regard to stunting and wasting 199 Tables 1.1 The Young Child Outcomes Index 19 1.2 The Young Child Environment Index 20 2.1 States by stunting (%), (NFHS 4) 49 2.2 Poshan Abhiyaan: programme targets 59 3.1 Participation in pre-school education varies by extent of disadvantage (2013–2014) 88 4.1 Top 10 states by percentage of slum and homeless population and number of working children under the age of 6 in India 123 4.2 Caste-wise malnourishment percentages among children under 5 125 4.3 Top 10 states with adverse SRB in India 127 4.4 Top 10 states by disability (%) 130 6.1 Centrally sponsored schemes, intended groups and ministries 184 6.2 Calculation of total national budget per child per year from 2014–2015 to 2018–2019 (INR) 185 6.3 Financial norms for supplementary nutrition under ICDS 186 6.4 Nutritional norms in ICDS 186 6.5 Expenditure on schemes within ICDS by MWCD from 2017–2018 to 2019–2020 187 6.6 Social sector spending in India across ministries as percentage of Union Budget 189 6.7 Social sector spending in India across ministries that administer social and welfare functions, as a percentage of India’s GDP, from 2014–2015 to 2019–2020 190 6.8 Expenditure across states for implementation of National ECCE Policy from 2014–2015 to 2017–2018 191 6.9 Reproductive and Child Health (RCH) budget of MoHFW from 2013–2014 to 2017–2018 192 6.10 Utilisation of approved budgets under the State Programme Implementation Plan for child health programme from 2009–2010 to 2015–2016 as a total budget of all the states 192 xii Tables 6.11 Funds released to states under Integrated Child Protection Scheme 192 6.12 Performance of ICPS from 2009–2010 to 2017–2018 193 6.13 States with highest population