Editorial Notes

[Editorial Notes] National well-being and counts that matter

India must not stick to decennial census operations and have a timely assessment of crucial indicators for the well-being of our human capital.
By IASToppers
September 02, 2020


  • Introduction
  • Present Issues
  • Valuable parameters
  • Way Forward
  • Conclusion

National well-being and counts that matter

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In India, a significant proportion of pregnancies start without the consent of the woman. The intergenerational impact of an unwanted and anxiety-loaded pregnancy cannot be quantified by current clinical or epidemiological tools. Measuring and tracking such matters is critical to an individual, community as well as for national well-being.

Present Issues:

1. Still Births:

  • Not every pregnancy ends up in a live birth.
  • Pregnancy needs to be supported by a fully functional health-care system, which can anticipate complications before time and facilitate a safe delivery.
  • Current stillbirth numbers in India are large, inadequately recorded and sometimes misrecorded as early neonatal deaths.
  • A young, short and under-schooled woman are more prone to have a bad pregnancy outcome or a smaller than expected baby.

2. Low birth weight:

  • Birth weight is a complex outcome which can reveal the health and nutrition condition of a woman and the newborn.
  • In India, a large number of women are anaemic, malnourished or under-nourished, which leads to low birth weight of the newborn.
  • Tracking average birthweights by district and sub-district regularly can be done to lay out plans for food security, the status of women and delivery of primary health care.

Valuable parameters:

  • India must not stick to decennial census operations and have a timely assessment of crucial indicators for the well-being of our human capital.
  • The valuable indicators should be measured frequently and at different life stages.
  • Some of the indicators include:
    • Birthweights
    • Heights and weights of children when they enter school
    • School completion rates
    • Age, height and weight of a first-time pregnant woman
    • The number of women in the formal workforce on a par with men in terms of earning.

Way Forward:

1. Height-weight proportions:

  • There are challenges for proper growing up (both physical and mental) of a child if the height-weight proportions at age five are not normal.
  • A good start gives a great advantage and can be achieved through adequate nutrition.
  • This starts from breastfeeding, then locally available weaning and complementary foods; and vaccines for preventable or easily treatable illnesses.
  • This marker must be recorded for every child who enters school for a correlation with birthweights at the district level, to understand the big picture and deal with it.

2. Improved learning:

  • Schooling in India shows low school completion rates, gender, rural-urban or parental income divides.
  • India can bring down its maternal mortality ratios, neonatal and under-five mortality rates, through delayed marriages and exercise of reproductive choices by its empowered young women.
  • This must begin with schools which have low dropout rates, proper reproductive education, education regarding gender sensitization, and vocational education, particularly for women.
  • The level of nutrition can be partially addressed through protein-rich mid-day meals.
  • Deworming, school toilets, sanitary pads and bicycles for girls are progressive policy steps in the right direction.
  • Teaching school-leaving girls and boys the notion of consent, and also the basics of contraception will ensure every pregnancy will be a desired.

3. Timely data and assessment:

  • Timely data assessment can help to gauge the problems in real-time and to take corrective actions where needed.
  • Public health is about people, their continued well-being, and not just about controlling disease outbreaks.
  • Timely, disaggregated, multidimensional data helps immensely in ensuring collective well-being, physical, mental and social.


India can reap its demographic dividend, provided if they are in a state of well-being. An uneducated, malnourished and vulnerable population will add to the existing burdens of the country.

Addressing this requires a whole of life and the whole of society approach, and measuring the outcomes. It is expected that National Health Policy, 2017 and the New Education Policy drive India towards a true demographic dividend.

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