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= CD IN INDIA = Child development in India is the biological, psychological, and emotional changes which children in India experience as they grow through early childhood into teenagerhood.

Child development has a major influence on personal health and at a national level the health of people in India. In India, children are a major part of the national disease burden.

Challenges with water supply and sanitation in India, alongside other environmental health problems including pollution-related diseases are difficult to fix and greatly affect children. As a result, a large demographic of Indian children receive little to no vaccination and usually contract a number of vaccine-preventable infectious diseases.

Although India has experienced moderate success with its Midday Meal Scheme which provides feeding for 10 crore children daily, generally, the country lags behind in its nutrition missions. About 40% of children in India experience malnutrition or stunted growth due to lack of access to healthy meals.

= EARLY CHILDHOOD DEVELOPMENT = Early childhood development (ECD) describes those biological and psychological changes that accompany the growth of children from conception till age six (6).[1] Within other frameworks, the definition of ECD is extended to age eight. These frameworks take cognizance of those changes that occur during a child’s transition to primary level education. Notably, more than 80% of a child’s brain growth occurs during this period and forms the foundation for every aspect of a child’s future.[2]

Under the right conditions, children develop properly and lay foundations for a good life but suffer various forms of brain impairment in the absence of these conditions.[3] Significant consequences resulting from this range from lower IQ and greater vulnerability to illness, to lesser academic accomplishments, lower productivity and meagre earnings. Basically, right conditions describe a matrix of appropriate nutrition, good health and care from breastfeeding, access to health services, and parental involvement, within which a child grows.[4]

= CHILD DEVELOPMENT MARKERS = Age, income, and locality are generally accepted common markers used by researchers and experts when performing statistical examinations of child development. These markers show considerable differences in the India context.

FIRST 1000 DAYS
A general rule identifies the first 1000 days after birth as a crucial child development period and recommends proper planning to give children the best possible start during this period. Experts recommend that babies should breastfeed immediately after birth to take in colostrum. In India, social taboos and a number of maternal health challenges that put nursing mothers at risk of maternal mortality are prevailing factors that prevent mothers from giving colostrum to their newborns.

After childbirth, easy and regular access to primary care from a doctor for newborns greatly improves their health outcomes. This includes regular visits for young children to a doctor’s office for vaccination. Children in poor families are less likely to access the care they need.

PRE-ADOLESCENCE
Preadolescence is the period that marks the end of early childhood and the beginning of puberty. During this period, girls need proper education to prepare them for menstrual hygiene management. A 2020 report showed that about 50 percent of girls in India get their first information about menstruation only after seeing their first period. Girls who are prepared for this have better development outcomes.

= TRENDS IN CHILD DEVELOPMENT = Achieving optimum child development begins with implementing certain measures prior to conception and requires proper nourishment for babies and their mothers, availability of educational opportunities, isolation from threatening situation, and abundance of caregiver-interactions that are stimulating, responsive, and emotionally supportive.[1] The first post-birth thousand days are considered to be crucial due to the extreme adaptability of children’s brains in this stage and near irreversibility of early deficits once children are grown past this stage.[2]

Major disruptions that alter optimum early childhood development are initiated when the physical, psychological and social context a child grows up in plays host to negative factors. These negative factors vary in intensity and range from neglect and lack of cognitive stimulation opportunities, to parental ill-health and domestic abuse.[3][4] Children who are affected by a number of these negative factors, especially those in low- and middle-income communities, are in danger of compounded detrimental burden which diminishes their well-being.[5][6]

On a long-term perspective, India’s progress in child development has been indexed on one hand by reducing infant mortality rate and on the other hand by encouraging healthy growth through immunization and supplementation. From 2000 to 2014, infant mortality experienced a drop, moving from 66 to 39 deaths per 1,000 live births. This positive development was paired by increased DPT immunization rates which rose from 58% to 83%. Progress, however, has been generally uneven.[7]

A study performed in 2008 reported that nearly 160 million children under the age of six lived in India. Generally, these children faced major challenges of malnutrition and healthcare,[8] indexed by approximately one-tenth of children in India suffering from diarrhoea and nearly one-sixth suffering from fever. Also, about 50 percent of children under the age of 3 went without full immunization, many often beginning but hardly completing immunization courses.[9]

India experienced high prevalence of malnutrition for over thirty years, despite increasing agricultural productivity and substantial economic growth. Relative improvements from starvation and undernutrition have been recorded, however, general outlook on nutrition and health reveals weak progress. Many of these are attributed to poverty across a large demographic, poor lifestyle choices, particularly spending patterns which favor festivals and non-essentials over balanced staple diet, and high rates of infectious and chronic diseases.[11]

Considerable advances have been made in addressing stunting, with a six percent decrease from its initial halfway mark. However, according to two National Family Health Surveys conducted at both ends of an eight-year period, the percentage of undernourished children in India barely changed.[12] And this is accompanied by a reduction in full vaccination coverage, leading to an increase in the India demographic suffering from anemia.[12]

The population in India continues to increase swiftly and this means that the government and its service providers are reaching for a moving target, which has produced slow progress and negatively impacted the nation’s economy. Micronutrient deficiencies alone (one component of underdevelopment) may cost India US$2.5bn annually, as reported in a study by the World Bank.[10] Also, shortage in adult annual income for stunted children averages 19.8%.

= INEQUALITIES IN CHILD HEALTH AND DEVELOPMENT = Evidently, pregnancy and early childhood conditions have wide-ranging and long-lasting effects on children, producing major impacts on their health and well-being in adulthood. The connection between micro level and macro level effects have also been demonstrated. An important example is the robust international associations between health in early childhood and economic indicators such as GDP per capita.[1][2] Hence, childhood development is considered a key factor in achieving the ambitious global Sustainable Development Goals.[3]

These associations are backed by a growing academic consensus, however, policymakers in low-income communities in India are lagging behind in factoring this development into their programming. Major drawbacks of this attitude are insufficient funding and regulatory oversight for programs that practically improves children welfare in the nation.[4] This works out in a number of ways: 45% of children under the age of 3 in India experience stunting, a form of severe malnutrition in which children have gone without proper nutrition for extended periods of time; and 23% experience wasting, a form of acute malnutrition in which children have not received proper nutrition recently, or have been seriously sick.[6]

From state to state, child health and wellbeing remains widely unequal, both in its level and its improvement rates. Data shows major deviations between Indian states. Madhya Pradesh holds the record for highest rate (60%) of under-five malnutrition, with Kerala among the lowest (23%).[6] Bihar, Madhya Pradesh, Uttar Pradesh and Rajasthan together account for over 43% of all underweight children in India.[9] Maharashtra and Gujarat experience high undernutrition rates irrespective of their high per capita incomes, and vaccination rates have fallen despite economic growth in Gujarat.[6]

Considering childhood death, Uttar Pradesh and Madhya Pradesh have an infant mortality rate that is several times higher than those of Kerala, and there exists a 40%+ points gap between the most and the least vaccinated states. Other vulnerable states are Jharkhand and Orissa. Tamil Nadu is known for its major advances in child development. However, there exists serious underdevelopment in certain communities in best performing states.[6] Also, substantial disparities exist within states, where intra-state variations are nearly as serious as inter-state. Rural areas’ infant mortality rates are over 1.5 times those of their urban counterparts. Likewise, the most vaccinated districts are more than 30 percentage points distanced from the least vaccinated districts within same state.[5]

Well known tools for combating these inequalities include provision of vital micronutrients; vaccination against life-threatening diseases; provision of clean water and improved sanitation; and prevention and immediate treatment of communicable diseases.[5]

Child development problems facing India are part of a larger issue in that part of Asia. The nutritional situation in India is one of the poorest in relation to other nations of the world, using statistics of prevalence of underweight, stunting or wasting.[8] Prevalence rates in India are almost as much as in poorer countries such as Bangladesh and Nepal, nearly twice as much as in Africa, and eight times as much as in Latin America and the Caribbean. 40% of the world’s malnourished children are in India, as well as 35% of the developing world’s low-birthweight infants. India accounts for almost one-fifth of the world’s under-five deaths with over 2 million under-five deaths. Proper children nutrition could prevent at least 50% of these deaths.[7]

ADVERSITIES CONTRIBUTING TO POOR CHILD DEVELOPMENT
Proven facts have shown that general health and wellbeing, as well as success in life are fully influenced by early childhood. Therefore, Early Child Development programs produces benefits for children, their families, and the community. The impact of Early Childhood Development programs has been mapped on to earlier school enrolment, higher school completion rates, better nutrition and improved health, reduced child morbidity and mortality, improved psychological and social traits, and increased earning ability and economic sustainability in adulthood.[10][11]

= CHILD UNDERDEVELOPMENT = Childhood development is a product of related factors that can be categorized under nutrition, health and care. Among others, malnutrition and poor healthcare are, therefore, major drivers of underdevelopment.[1]

NUTRITION
From a biological perspective, enough protein and energy, coupled with ample supplies of micronutrients make up a maximized matrix under which child growth and development properly proceeds. In India, there is widespread undernutrition as a result of poor feeding practices, low dietary consumption, and lack of prevention or treatment for communicable diseases.[2] Moreover, 22% of babies in India are born with low birthweight and face risks of undernutrition and illness even before birth.[3] This highlights the poor attention given to maternal health and nutrition before and during pregnancy, which is reflected in statistics that identify 36% of Indian women as underweight (too thin for their height) and 55% as anemic.[3]

Breastfeeding provides all the nutrients and calories babies need and is considered a central component of infant nutrition, to be taken exclusively by babies beginning immediately at birth throughout the first six months, and frequent enough to meet babies’ appetites.[4][5][6] In India, most mothers with young children breastfeed but 75% of children are not breastfed in the first hour after birth. Over 50% of mothers introduce other sources of nutrition for their babies besides breast milk within the first three days of life, and only 28% of babies are exclusively breastfed after five months from birth.[3]

A 2017 study reported that within the first 1000 days, 57% of newborns in India transition from breastfeeding to solid nutrient sources, 48% get enough frequent nutrition, 33% have access to a variety of nutrient sources, and 21% get overall adequate nutrition.

For school age children, India's Midday Meal Scheme has been a major success which daily provides a hot healthy meal to 10 crore children. Currently, the program is adapting the meals according to research recommendations to meet more specific nutrition needs.

From the 1970s, India has had programs to prevent vitamin A deficiency, but nowadays this problem is much less. Vitamin D deficiency is a challenge which the government is addressing with food fortification.

HEALTH
In child development, the health factor is closely related with nutrition. Young children are vulnerable to diarrhea, intestinal worms and pneumonia as well as infectious diseases like measles, malaria and TB. These impact children’s well-being directly and indirectly through damages to children’s ability to absorb nutrients.[12]

Lack of preventive measures including proper sanitation is a primary factor of poor health conditions in India. Adequate sanitation is enjoyed by only 50% of the urban population and 18% of the rural population. A mere 21% of Indian homes safely dispose of children’s stool.{3] Caregivers’ practices also impact children’s health. In India, a number of harmful practices are widespread, including depriving newborns of the first milk (anti-body rich ‘colostrum’), keeping babies under too low temperature and, in some areas, not feeding children during illness.[2]

CARE
Here, care is considered in a broad sense and covers social and emotional care, including interaction, affection, safety and comfort.[13] For babies and young children, these include positively engaging and responding to them through looks, touch, and speech. For older children, this implies quality pre-school education.[13][14] For all children, care requires positives such as parental interest, attention and involvement, as well as isolation from negatives such as stress and violence.[12][14]

In many Indian homes, the family including the children are victims of poor care. A large percentage of parents resume full-time jobs almost immediately after birth, and older children are often responsible for taking care of their younger ones.

Maternity entitlements are generally only available to women working in the formal sector, comprising 7% of the female workforce. Crèche and pre-school provision are limited in terms of access and quality. the FORCES network in Delhi estimates that there are 23,000 crèches available under existing schemes, compared with potential demand of 800,000.[15]

OTHER SOCIAL ISSUES
Various social issues relate to child development in India. Poverty presents particular challenges for street children in India, child workers in India, and children trafficked in India. Children's health matters relating to gender include gender inequality in India, female infanticide in India, and certain aspects of child marriage in India.

POVERTY
Main article: Poverty in India

Children in families below the poverty line regularly face health challenges which children in families with higher income may never face. In general, any sort of health problem is worse for children who do not have easy access to basic healthcare. Oral health issue is one of many medical problems that are strongly linked to poverty. Kerala’s poverty reduction programs produced positive changes in children's health, and their model has been proposed by several commentators as a pragmatic and beneficial model for the general Indian populace.

ENVIRONMENTAL HEALTH
Main article: Environmental Health

In India, children suffer greatly due to environmental health problems. Air pollution, water pollution, health effects of pesticides, and poor sanitation are nation-wide problems requiring government intervention and planning to address.

Urbanization in India is increasing faster than most Indian cities are developing. Within cities, individual income (or family income) affects access to healthcare and causes substantial healthcare disparities.

VACCINATION
Main article: Vaccination in India

Of all countries, India has the highest number of deaths of children under age five. Most of these deaths result from vaccine-preventable diseases. Better vaccine coverage will greatly improve children’s health and lives in India. In theory, all children would get their vaccinations on time. For the BCG vaccine against tuberculosis and leprosy, over one-third of Indian children receive it in time and at least 87% have received it by age 5. For DPT vaccine against diphtheria, pertussis, and tetanus, about one-fifth receive it in time and about two-thirds have received it by age 5. For the meningococcal vaccine against meningococcal disease 34% get it on time and 76% get it by age 5.

Children in slums more often lack vaccine protection.

REGIONAL VARIATION
A 2012 nutrition study in Maharashtra reported that homes and families had a supply of food but faced the challenge of limited variety in nutritious food sources.

Another report from a study conducted in Haryana made recommendations for access to cleaner burning fuel as a part of better household aid quality which would facilitate improved children's health.

SOCIETY AND CULTURE
A 2017 study showed that Indian government’s policy and delivery systems facilitated achieving improvements in child nutrition. The challenges to overcome were financing such social programs, sustaining research to keep programs on track, and developing urban capacity to grow programs.

= GOI INITIATIVES AND IMPACTS = Several schemes by the Government of India (GOI) are directly or indirectly aimed at facilitating child development:[1]


 * 1) The Mid-day Meal scheme (MDM), established to eradicate hunger among children in the classroom;
 * 2) The National Rural Health Mission (NRHM), launched to decrease maternal deaths by providing effective healthcare to rural populations;
 * 3) Reproductive and Child Health Program, a component of the NHRM to cover maternal and child health, reproductive health, family planning, antenatal check-ups and safe delivery;
 * 4) National Maternity Benefit Scheme (NMBS) launched in 1995 and modified to Janani Suraksha Yojana (JSY) in April 2005 to make cash available for any scheduled tribe woman who undergoes ante-natal check-ups and institutional delivery;
 * 5) Public Distribution Scheme (PDS), an old and vast Indian safety net system under which essential commodities like wheat, rice and sugar are sold at subsidized rates to people below the poverty line through a system of fair price shops (FPS).
 * 6) The National Rural Employment Guarantee Act (NREGA), a flagship scheme founded in 2005 to make official provision for 100 days of employment in every financial year to adult in rural homes, who are willing to take up untrained labor for stipulated minimum pay. In practice, this scheme has been mainly used by women.[2][3]

In 1972, a joint survey conducted by a couple of departments within the Indian government revealed that child care programs had failed in delivering on their original objectives. Resource constraints, inadequate coverage, and a fragmented approach were the major factors identified for the failure of these programs. India’s Integrated Child Development Services (ICDS) was launched three years later with these objectives:


 * 1) Establish a framework for children’s physical, psychological and social development;
 * 2) Improve the nutritional and health status of children in the age group 0-6 years and mitigate morbidity, mortality, malnutrition, and school dropout;
 * 3) Enhance mothers’ ability to address children’s primary needs through better healthcare and education; and
 * 4) Achieve effective co-ordination of policy and implementation among various departments responsible for child development.[4]

In its 1986 Policy on Education, India prioritized early childhood care and education services as integral inputs into primary education and as significant support for women who desire to work in the formal sector.

ICDS
For more than 30 years, the GOI has concentrated efforts to improve child development through the Integrated Child Development Services (ICDS) scheme. The program is encompassing in design and, in combination with other government initiatives, makes available all necessary solutions to tackle the problem.[5]

The ICDS is appraised to be the world’s largest integrated early childhood program and one of the most all-inclusive family welfare programs, operating through over 40,000 centers established across the nation. It offers public health support services that tackle nutrition, vaccination, and learning, to pre-school babies and their mothers.

ICDS services are provided through a matrix of projects in various localities. Initially, the network comprised 3907 projects, spread across 70% of India’s community development urban areas and rural settlements.[6] Projects in rural or urban areas attend to about 100,000 residents grouped into 100 centers, and ethnic-based projects provide services for about 35,000 residents grouped into 50 centers. These centers are operated by Anganwadi workers and helpers, who receive 7 months of structural and community-informed training. Projects are handled by a team of supervisors and a Child Development Officer who is saddled with implementing and managing the entire project in their jurisdiction.[8]

Annually, the government spends at least $10 on each child that receives its ICDS services.[7] The core services offered to children under the age of six are supplementary nutrition, immunization, primary healthcare, recommendations to health facilities, and informal learning. Tetanus immunization, supplementary nutrition and health education are the services provided for mothers.[9]

The ICDS had expanded to a capacity of 6120 operational projects and over 100,000 centers, reaching over fifty-eight million children and over ten million pregnant or lactating women in 2008, in comparison to twenty-seven and a half million children attended to in 2000.[10]

CHALLENGES FACING ICDS
After thirty years of continuously expanding funding and operation, the ICDS stills falls short of its stated objectives and faces a number of challenges. Its widespread coverage is weakened by lack of continuity and consistency in the scope and thoroughness of solutions provided across the country.[11] The nation’s health and education programs impacts are indexed by the following:


 * 1) In India, almost half of the children are undernourished;
 * 2) Half of worldwide hungry demographic are localized in India;
 * 3) India falls close to the bottom of the world ranking in public health spending;
 * 4) In 2009, India dropped in its MDG ranking eight places below its previous position;
 * 5) In 2008, 10.7% of the nation’s budget went to education but only 61.9% of Indians aged 15+ years were considered literate;
 * 6) A modest reduction in childbirth-associated maternal mortality from 327 to 254 per 100,000 live births occurred over a period of 16 years.
 * 7) Annually, about 400,000 infant mortalities occur within the first 24 hours after birth, 90 percent of which are due to vaccine-preventable diseases;
 * 8) India reduced mortality due to measles by 23% between 2000 and 2008, but accounted for 66% of global measles mortality in 2008.
 * 9) India’s measles vaccination coverage increased from 54% in 2000 to 70% in 2008, but this coverage is much lower than the 2008 global coverage of 83%;
 * 10) The percentage of underweight children below three years only slightly changed over a period of 8 years.[12][13][14]

These negative trends in children’s nutrition in India happened regardless of the government of India’s move to give greater importance and more funding to the extension of the ICDS program. In 2006, the World Bank reviewed the ICDS and ascertained that its services made minimal impact on overall nutritional outcomes, stating that its only substantial impact was a reduction in male chronic malnutrition indicated in the 1992 review, though not in later survey. No important effect on girls were recorded.[15]

By 2008, the ICDS program had shown some undesirable effects in certain regions. Being underweight was more probable for children in ICDS village in Northeast areas.[6]

= PRIVATE SECTOR IMPACT = Generally, there is scarce information on India NGOs and very few have a focus on Early Childhood Development. A small group of organizations focus on maternal and child health and nutrition, but do not often address children’s informal pre-school education needs.[1]

The efforts of a number of privately funded organizations have, however, positively impacted ECD in India. Most notable are the efforts of the Aga Khan Foundation.

The Aga Khan Education Service (AKES) has developed capability in the ECD sector and have operation bases in Gujarat, Maharashtra and Telengana, comprising 27 ECD facilities, ranging from “in-school” set ups and isolated centers, to community-based centers across rural, semi-urban, and urban areas.[2]

The organization emphasizes employing locally relevant curricula, testing with various training methods and support for guardians, caregivers and informal teachers, and finding effective and efficient methods of stimulating communal involvement. Their programs are designed with a special focus on marginalized demographics, especially girls.[2]

AKF also provides support for government-owned local resource centers that grow into sustainable institutions capable of providing resources for homes and their children.[2]

A review of AKF’s ECD programs carried out in 2013 found that children who engaged in informal learning prior to school produced better performances on achievement assessments than children who had not been so engaged, and they were better ready for structured learning than other students their age. AKES’s efforts in all its missions and programs converge primarily on meeting the needs of the child.[2]

AKES provides social and psychological stimulation for guardians and caregivers in each locality to co-ordinate efforts in raising children. The organization also provides a well-rounded, neuroscience informed, developmentally appropriate, culturally relevant and nurturing practice for children. AKES invests great effort and resources into making regular upgrades to its programs in accordance with current worldwide standards and ensures that its Early Childhood Programs make available safe educational platforms to tend to the learning needs of children.[2]

= REFERENCES =

CD IN INDIA


 * 1) 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.
 * 2) 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.

ECD IN INDIA


 * 1) Starting Strong
 * 2) Citizens’ Initiative for the Rights of Children Under Six (2006) Focus on Children Under Six. www.righttofoodindia.org.
 * 3) Shastri, P. http://www.livemint.com/ Articles/2008/05/21000613/Half-of-India8217s-kids-wil.html [accessed on 4 January 2009]
 * 4) Garcia, M., Pence, A. and Evans, J.L., ed. (2008) Africa’s Future, Africa’s Challenge: Early Childhood Care and Development in Sub-Saharan Africa.

CHILD DEVELOPMENT MARKERS


 * 1) 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 2020-04-05). PMC 6984033. PMID 32030072.
 * 2) 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.
 * 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.

TRENDS IN CHILD DEVELOPMENT


 * 1) World Health Organization, United Nations Children’s Fund, World Bank Group. Nurturing care for early childhood development: a framework for helping children survive and thrive to transform health and human potential [Internet]. Geneva: World Health Organization; 2018
 * 2) Shonkoff JP, Phillips DA. From neurons to neighborhoods: The science of early childhood development. National Academies Press; 2000
 * 3) Cronholm PF, Forke CM, Wade R, Bair-Merritt MH, Davis M, Harkins-Schwarz M, et al. Adverse Childhood Experiences: Expanding the Concept of Adversity. Am J Prev Med. 2015;49: 354–361. pmid:26296440
 * 4) Walker SP, Wachs TD, Gardner JM, Lozoff B, Wasserman GA, Pollitt E, et al. Child development: risk factors for adverse outcomes in developing countries. The Lancet. 2007;369: 145–157.
 * 5) Walker SP, Wachs TD, Grantham-McGregor S, Black MM, Nelson CA, Huffman SL, et al. Inequality in early childhood: risk and protective factors for early child development. The Lancet. 2011;378: 1325–1338.
 * 6) Wachs TD, Rahman A. The nature and impact of risk and protective influences on children’s development in low-income countries. Handb Early Child Dev Res Its Impact Glob Policy. 2013; 85–122.
 * 7) IPF-2016-Paper-Achyuta-Prashatnt-Sam
 * 8) UNICEF (2008) The State of the World’s Children 2008: Child Survival.
 * 9) Ministry of Health and Family Welfare, Government of India (2005/6) National Family Health Survey (NFHS-3). www.nfhsindia.org/abt.html.
 * 10) Gragnolati, M., Shekar, M., Das Gupta, M., Bredenkamp, C. and Lee, Y.-K. (2005) India’s Undernourished Children: a Call for Reform and Action. World Bank.
 * 11) Banerjee, AV & Duflo, E. (2006). The economic lives of the poor. Journal of Economic Perspectives 21 (1), pp 141-168.
 * 12) Ministry of Health and Family Welfare, Government of India (2005/6) National Family Health Survey (NFHS-3). www.nfhsindia.org/abt.html.

INEQUALITIES IN CHILD DEVELOPMENT


 * 1) Almond, D., Doyle Jr, J.J., Kowalski, A. and Williams, H., 2010. Estimating Marginal Returns to Medical Care: Evidence from At-Risk Newborns. The Quarterly Journal of Economics, 125(2): 591-634.
 * 2) Weil, D.N., 2014. Health and economic growth. Handbook of Economic Growth, 2, pp. 623-82.
 * 3) Daelmans B, Darmstadt GL, Lombardi J, Black MM, Britto PR, Lye S, et al. Early childhood development: the foundation of sustainable development. The Lancet. 2017;389: 9–11.
 * 4) Britto, P.R., Engle, P.L. and Super, C.M., 2013. Handbook of early childhood development research and its impact on global policy. Oxford University Press.
 * 5) IPF-2016-Paper-Achyuta-Prashatnt-Sam.pdf
 * 6) Ministry of Health and Family Welfare, Government of India (2005/6) National Family Health Survey (NFHS-3). www.nfhsindia.org/abt.html.
 * 7) IFPRI (2008) Despite efforts, why does child malnutrition persist in India? International Food Policy Research Institute. www.ifpri.org/media/BeijingPlus10/briefIndia.pdf.
 * 8) Gragnolati, M., Shekar, M., Das Gupta, M., Bredenkamp, C. and Lee, Y.-K. (2005) India’s Undernourished Children: a Call for Reform and Action. World Bank.
 * 9) Save the Children India (2009) Freedom from Hunger for Children under Six: An Outline for Save the Children and Civil Society involvement in Childhood Undernutrition in India.
 * 10) Reynolds, AJ, Temple, JA, Robertson DL & Mann EA (2001). Long-Term Effects of an Early Childhood Intervention on Educational Achievement and Juvenile Arrest: A 15-Year Follow-Up of Low-Income Children in Public Schools. Journal of the American Medical Association, 285 (18), pp. 2330-2346.
 * 11) Young, M. (1996). Early Child Development: Investing in the Future. The World Bank, ISBN 0-8213-3547-2, Washington, DC.

CHILD UNDERDEVELOPMENT


 * 1) https://www.thinknpc.org/wp-content/uploads/2018/07/Starting_strong.pdf
 * 2) IFPRI (2008) Despite efforts, why does child malnutrition persist in India? International Food Policy Research Institute. http://www.ifpri.org/media/BeijingPlus10/briefIndia.pdf.
 * 3) Ministry of Health and Family Welfare, Government of India (2005/6) National Family Health Survey (NFHS-3). http://www.nfhsindia.org/abt.html.
 * 4) Gupta, A. (2006) Infant and Young Child Feeding: An Optimal Approach. Economic and Political Weekly.
 * 5) Bhutta, Z.A., Ahmed, T., Black, R.E., Cousens, S., Dewey, K., Giugliani, E., Haider, B.A., Kirkwood, B., Morris, S.S., Sachdev, H. and Shekar, M. (2008) What works? Interventions for maternal and child undernutrition and survival. The Lancet, 371.
 * 6) Greiner, T. (2004) Programs to Protect, Support and Promote Breastfeeding, in Encyclopedia on Early Childhood Development.
 * 7) 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. PMID 29032627.
 * 8) 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.
 * 9) 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.
 * 10) 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.
 * 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.
 * 1) Walker, S.P., Wachs, T.D., Meeks Gardner, J., Lozoff, B., Wasserman, G.A., Pollitt, E. and Carter, J.A. (2007) Child development: risk factors for adverse outcomes in developing countries. The Lancet, 369. 13 January 2007.
 * 2) Citizens’ Initiative for the Rights of Children Under Six (2006) Focus on Children Under Six. http://www.righttofoodindia.org.
 * 3) The Impact of Early Adversity on Children’s Development. National Symposium on Early Childhood Science and Policy. http://www.developingchild.harvard.edu.
 * 4) Bajaj, M. (2007) ICDS in Delhi: a reality check. Delhi FORCES (Neenv). http://www.righttofoodindia.org/ data/neenv2007icds-delhi-reality-check.doc.
 * 5) Nigam, S (1994). "Street children of India -- a glimpse". Journal of Health Management. 7 (1): 63–7. PMID 12289892.
 * 6) 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.
 * 7) 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.
 * 8) Subramanian, Samyukta (15 October 2019). "India's policy on early childhood education". Brookings Institution.
 * 9) 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.
 * 10) Nour, NM (2009). "Child marriage: a silent health and human rights issue". Reviews in Obstetrics & Gynecology. 2 (1): 51–6. PMC 2672998. PMID 19399295.
 * 11) 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". Lancet. 394 (10194): 249–260. doi:10.1016/S0140-6736(19)31146-8. PMID 31327369.
 * 12) 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.
 * 13) 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.
 * 14) 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.
 * 15) 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.
 * 16) 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.
 * 17) 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. PMID 29032621.
 * 18) 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". doi:10.1596/978-1-4648-0522-6/ch12 (inactive 2020-04-05). PMID 30212113.
 * 19) 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.

GOI INITIATIVES AND IMPACT


 * 1) Citizens’ Initiative for the Rights of Children Under Six (2006) Focus on Children Under Six. http://www.righttofoodindia.org.
 * 2) Save the Children India (2009) Freedom from Hunger for Children under Six: An Outline for Save the Children and Civil Society involvement in Childhood Undernutrition in India.
 * 3) World Bank India (2006) Recent Findings on ICDS and its Performance. World Bank India Nutrition Team.
 * 4) Kaul V. (1993). Integrated child development services in India. Childhood, 1 (4), pp 243-245.
 * 5) https://www.thinknpc.org/wp-content/uploads/2018/07/Starting_strong.pdf
 * 6) https://www.researchgate.net/publication/221921154_Three_Decades_of_the_Integrated_Child_Development_Services_Program_in_India_Progress_and_Problems
 * 7) Dasgupta, Rajib, Purnamita Dasgupta, and Ankush Agrawal. "Decline in immunization coverage across well-performing districts in India: an urban conundrum?." The Indian Journal of Pediatrics 81.9 (2014): 847-849.
 * 8) Lokshin, M, Das Gupta, M, Gragnolati, M & Ivaschenko O (2005). Improving Child Nutrition? The Integrated Child Development Services in India. Development and Change 36 (4), pp 613–640.
 * 9) Muralialharari R, Kaul V (1993). Responding to children’s needs: Integrated Child Development Services in India. In: Elderling L, Leseman P. Early intervention and culture:  preparation for literacy; the interface between theory and practice. UNESCO, ISBN 92-3-102937-1, Paris.
 * 10) Kapil, U (2002). Integrated Child Development Services (ICDS) scheme: a program for holistic development of children in India. Indian Journal of Pediatrics; 69 (7), pp 597-601.
 * 11) https://www.opml.co.uk/projects/early-childhood-development-nutrition-india
 * 12) UNESCO (2010). Global Education Digest 2010. UNESCO Institute of Statistics, ISBN: 978-92-9189-088-0, Quebec.
 * 13) United Nations (2010). Millennium Development Goals 2010. New York: United Nations, ISBN 978-92-1-101218-7, New York.
 * 14) World Health Organization (2009). Global Health Risks: mortality and burden of disease attributable to selected major risks. WHO, ISBN 978 92 4 156387 1, Geneva?
 * 15) Lokshin, M, Das Gupta, M, Gragnolati, M & Ivaschenko O (2005). Improving Child Nutrition? The Integrated Child Development Services in India. Development and Change 36 (4), pp 613–640.

PRIVATE SECTOR IMPACTS


 * 1) https://www.thinknpc.org/wp-content/uploads/2018/07/Starting_strong.pdf
 * 2) https://www.akdn.org/where-we-work/south-asia/india/early-childhood-development-india