- Present Issues
- Valuable parameters
- Way Forward
National well-being and counts that matter
For IASToppers’ Editorial Simplified Archive, click here
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.
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.
- 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:
- 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.
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.