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Child development in India
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<h2 id="early-childhood-development">Early childhood development</h2> <p><a href="/facts/Early_childhood/CJsN2I43">Early childhood</a> is the stage in human development that occurs between <a href="/facts/Infant/gaEL1QL4">infancy</a> and approximately six years years of age.<a class="footnote-ref" id="fnref:4" href="#fn:4"><sup>4</sup></a> Other definitions extend ECD to age eight to account for changes that occur during a child's transition into primary level education.<a class="footnote-ref" id="fnref:5" href="#fn:5"><sup>5</sup></a> Children can develop brain damage in the absence of healthy conditions.<a class="footnote-ref" id="fnref:6" href="#fn:6"><sup>6</sup></a><a class="footnote-ref" id="fnref:7" href="#fn:7"><sup>7</sup></a> </p> <h2 id="child-development-markers">Child development markers</h2> <p>Common markers used by researchers and experts in the statistical examination of childhood development include, age, income, and locality. These show marked differences in the India context. </p> <h3>Age</h3> <h4>First 1000 days</h4> <p class="note">Main article: <a href="/facts/First_1000_days/6esffWEY">First 1000 days</a></p> <p>The first 1000 days is considered to be a critical period in child development that recommends planning to give a child the best possible start in their first 1000 days after birth.<a class="footnote-ref" id="fnref:8" href="#fn:8"><sup>8</sup></a> The general recommendation for babies is that they should <a href="/facts/Breastfeed/cdWXyYDX">breastfeed</a> soon after birth to get <a href="/facts/Colostrum/pd6LVQpf">colostrum</a>.<a class="footnote-ref" id="fnref:9" href="#fn:9"><sup>9</sup></a> Some factors which prevent mothers from giving colostrum to their newborns include maternal health challenges, including the risk of <a href="/facts/Maternal_mortality_in_India/fmcUEK39">maternal mortality</a> and social taboo.<a class="footnote-ref" id="fnref:10" href="#fn:10"><sup>10</sup></a> </p><p>After a child is born, regular access to <a href="/facts/Primary_care/7oDNVSE0">primary care</a> from a doctor improves health outcomes.<a class="footnote-ref" id="fnref:11" href="#fn:11"><sup>11</sup></a> Young children visiting a doctor get vaccinated.<a class="footnote-ref" id="fnref:12" href="#fn:12"><sup>12</sup></a> Children in impovrished families are less likely to have access to medical care.<a class="footnote-ref" id="fnref:13" href="#fn:13"><sup>13</sup></a> </p> <h4>Pre-adolescence</h4> <p><a href="/facts/Preadolescence/3sImdgGL">Preadolescence</a> is the period where <a href="/facts/Early_childhood/CJsN2I43">early childhood</a> ends, and <a href="/facts/Puberty/vjfPAKf4">puberty</a> begins. Girls at this time need education and preparedness to do <a href="/facts/Menstrual_hygiene_management/btvJvoz9">menstrual hygiene management</a>.<a class="footnote-ref" id="fnref:14" href="#fn:14"><sup>14</sup></a> A 2020 study reported that half of the girls in India get their first information about <a href="/facts/Menstruation/7cv4HzLe">menstruation</a> after their <a href="/facts/Menarche/EFzGSWMk">first menstrual cycle</a>.<a class="footnote-ref" id="fnref:15" href="#fn:15"><sup>15</sup></a> Girls who are prepared for this have better development outcomes.<a class="footnote-ref" id="fnref:16" href="#fn:16"><sup>16</sup></a> </p> <h2 id="trends-in-child-development">Trends in child development</h2> <p>Optimal child development starts before <a href="/facts/Conception_(biology)/g8u3UKzF">conception</a> and is dependent on adequate <a href="/facts/Nutrition/SMJ3Dhfs">nutrition</a> for mother and child, protection from threats, provision of learning opportunities, and caregiver interactions that are stimulating, responsive, and emotionally supportive.<a class="footnote-ref" id="fnref:17" href="#fn:17"><sup>17</sup></a> The first 1000 days of life 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.<a class="footnote-ref" id="fnref:18" href="#fn:18"><sup>18</sup></a> </p><p>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.<a class="footnote-ref" id="fnref:19" href="#fn:19"><sup>19</sup></a><a class="footnote-ref" id="fnref:20" href="#fn:20"><sup>20</sup></a> Exposure to multiple adversities poses a cumulative detrimental burden to a child's wellbeing, especially those in low- and middle-income communities.<a class="footnote-ref" id="fnref:21" href="#fn:21"><sup>21</sup></a><a class="footnote-ref" id="fnref:22" href="#fn:22"><sup>22</sup></a> </p><p>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.<a class="footnote-ref" id="fnref:23" href="#fn:23"><sup>23</sup></a> Around one in ten Indian children experience <a href="/facts/Diarrhea/6TBHaRdA">diarrhoea</a> and almost one in six experience fever. Half of children younger than three were deprived of full <a href="/facts/Immunization/f2NLoleW">immunisation</a>.<a class="footnote-ref" id="fnref:24" href="#fn:24"><sup>24</sup></a> </p> <h2 id="inequalities-in-child-health-and-development">Inequalities in child health and development</h2> <p>Childhood development is considered a key factor in achieving the ambitious global Sustainable Development Goals.<a class="footnote-ref" id="fnref:25" href="#fn:25"><sup>25</sup></a> 45% of Indian under-threes experience stunting, a measure of chronic malnutrition.<a class="footnote-ref" id="fnref:26" href="#fn:26"><sup>26</sup></a> </p> <h3>Prevalent factors in child underdevelopment</h3> <h4>Nutrition</h4> <p class="note">Main article: <a href="/facts/Malnutrition_in_India/gh4vp5bH">Malnutrition in India</a></p> <p>A 2017 study reported that 57% of newborns in their first 1000 days in India transition on time from <a href="/facts/Breastfeeding/cdWXyYDX">breastfeeding</a> to nutritious solid food; 48% get their meals frequently enough; 33% have enough food variety for nutrition, and 21% get overall adequate meals.<a class="footnote-ref" id="fnref:27" href="#fn:27"><sup>27</sup></a> </p><p>India's <a href="/facts/Midday_Meal_Scheme/2px3vqp4">Midday Meal Scheme</a> has been a major success for school-age children, which provides a daily hot healthy meal to 100 million children.<a class="footnote-ref" id="fnref:28" href="#fn:28"><sup>28</sup></a> Current trends in the program are adapting the meals based on research to meet more specific nutrition needs.<a class="footnote-ref" id="fnref:29" href="#fn:29"><sup>29</sup></a> </p><p>Since the 1970s, India has had programs to prevent <a href="/facts/Vitamin_A_deficiency/vxU5gh4k">vitamin A deficiency</a>, but this problem is much less nowadays.<a class="footnote-ref" id="fnref:30" href="#fn:30"><sup>30</sup></a><a class="footnote-ref" id="fnref:31" href="#fn:31"><sup>31</sup></a> <a href="/facts/Vitamin_D_deficiency/lWMkWjEm">Vitamin D deficiency</a> is a challenge that the government is addressing with <a href="/facts/Food_fortification/Yr96v3Jj">food fortification</a>.<a class="footnote-ref" id="fnref:32" href="#fn:32"><sup>32</sup></a> </p> <h4>Poverty</h4> <p class="note">Main article: <a href="/facts/Poverty_in_India/o7nHNGNp">Poverty in India</a></p> <p><a href="/facts/Child_poverty/rzWjx4Q8">Children in poverty</a> 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 <a href="/facts/Oral_health/p8b1zmts">oral health</a>.<a class="footnote-ref" id="fnref:33" href="#fn:33"><sup>33</sup></a> Kerala organized <a href="/facts/Poverty_reduction/qTXfx5c1">poverty reduction</a> programs and, after that, had better children's health.<a class="footnote-ref" id="fnref:34" href="#fn:34"><sup>34</sup></a> Various commentators have examined the Kerala model as an example of what might work elsewhere in India.<a class="footnote-ref" id="fnref:35" href="#fn:35"><sup>35</sup></a> </p> <h4>Environmental health</h4> <p class="note">Main article: <a href="/facts/Environmental_health/q1xceAL3">Environmental health</a></p> <p>Children in India are significantly affected by <a href="/facts/Environmental_health/q1xceAL3">environmental health</a> problems.<a class="footnote-ref" id="fnref:36" href="#fn:36"><sup>36</sup></a> Challenges such as air pollution, <a href="/facts/Water_pollution/SCUhUYqB">water pollution</a>, <a href="/facts/Health_effects_of_pesticides/tv7mAvcn">health effects of pesticides</a>, and <a href="/facts/Water_supply_and_sanitation_in_India/nPaMuPwS">sanitation</a> require government-level planning to fix and are challenging to address.<a class="footnote-ref" id="fnref:37" href="#fn:37"><sup>37</sup></a> </p><p><a href="/facts/Urbanization_in_India/hapNWnXh">Urbanisation in India</a> has been increasing more quickly than many cities can develop.<a class="footnote-ref" id="fnref:38" href="#fn:38"><sup>38</sup></a> There is a great disparity in access to healthcare within cities, depending on the money a person has.<a class="footnote-ref" id="fnref:39" href="#fn:39"><sup>39</sup></a> </p> <h4>Vaccination</h4> <p class="note">Main article: <a href="/facts/Vaccination_in_India/uDzbzqeI">Vaccination in India</a></p> <p>Of all countries, India has the highest number of deaths of children under age five.<a class="footnote-ref" id="fnref:40" href="#fn:40"><sup>40</sup></a> Most of these deaths are from <a href="/facts/Vaccine-preventable_diseases/umgVTbIP">vaccine-preventable diseases</a>.<a class="footnote-ref" id="fnref:41" href="#fn:41"><sup>41</sup></a> If children in India got vaccines, then their health and lives would be improved.<a class="footnote-ref" id="fnref:42" href="#fn:42"><sup>42</sup></a> </p><p>Ideally, all children would get their vaccinations on time. The <a href="/facts/BCG_vaccine/1hG40pC8">BCG vaccine</a> against <a href="/facts/Tuberculosis/ggPyovAl">tuberculosis</a> and <a href="/facts/Leprosy/FSjTpMEB">leprosy</a> 31% of children get it on time, and 87% get it by age 5.<a class="footnote-ref" id="fnref:43" href="#fn:43"><sup>43</sup></a> For <a href="/facts/DPT_vaccine/oRGy9jGc">DPT vaccine</a> against <a href="/facts/Diphtheria/IKFXNjAV">diphtheria</a>, <a href="/facts/Pertussis/LyrTdSeh">pertussis</a>, and <a href="/facts/Tetanus/1vukLxUU">tetanus</a>, 19% get it on time and 63% by age 5.<a class="footnote-ref" id="fnref:44" href="#fn:44"><sup>44</sup></a> For the <a href="/facts/Meningococcal_vaccine/FmWdsBCV">meningococcal vaccine</a> against <a href="/facts/Meningococcal_disease/uf5RYjFn">meningococcal disease</a>, 34% get it on time, and 76% get it by age 5.<a class="footnote-ref" id="fnref:45" href="#fn:45"><sup>45</sup></a> </p><p>Children in slums more often lack vaccine protection.<a class="footnote-ref" id="fnref:46" href="#fn:46"><sup>46</sup></a> </p> <h4>Other societal issues</h4> <p>Various difficult and social issues are related to child development in India. Poverty presents particular challenges for <a href="/facts/Street_children_in_India/4chyyt7e">street children in India</a>,<a class="footnote-ref" id="fnref:47" href="#fn:47"><sup>47</sup></a> <a href="/facts/Child_labour_in_India/5VjPhUIc">child workers in India</a>,<a class="footnote-ref" id="fnref:48" href="#fn:48"><sup>48</sup></a> and <a href="/facts/Child_trafficking_in_India/k6CjR1k1">children trafficked in India</a>.<a class="footnote-ref" id="fnref:49" href="#fn:49"><sup>49</sup></a> Children's health matters related to gender include <a href="/facts/Gender_inequality_in_India/dxNnRrQH">gender inequality in India</a>,<a class="footnote-ref" id="fnref:50" href="#fn:50"><sup>50</sup></a> <a href="/facts/Female_infanticide_in_India/kHaa5YDD">female infanticide in India</a>,<a class="footnote-ref" id="fnref:51" href="#fn:51"><sup>51</sup></a> and certain aspects of <a href="/facts/Child_marriage_in_India/FDMYSW19">child marriage in India</a>.<a class="footnote-ref" id="fnref:52" href="#fn:52"><sup>52</sup></a> </p> <h2 id="regional-variation">Regional variation</h2> <p>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.<a class="footnote-ref" id="fnref:53" href="#fn:53"><sup>53</sup></a> </p><p>A report on Haryana recommended access to cleaner-burning fuel to improve children's health through improved household aid quality.<a class="footnote-ref" id="fnref:54" href="#fn:54"><sup>54</sup></a> </p> <h2 id="society-and-culture">Society and culture</h2> <p>A 2017 study reported that India's government has policy and delivery systems that are favorable for achieving improvements in child nutrition.<a class="footnote-ref" id="fnref:55" href="#fn:55"><sup>55</sup></a> The challenges are financing such social programs, researching to keep them on track, and urban capacity to grow programs.<a class="footnote-ref" id="fnref:56" href="#fn:56"><sup>56</sup></a> </p> <h2 id="private-sector-impact">Private sector impact</h2> <p>The efforts of several privately funded organizations, including the Aga Khan Foundation, have positively impacted ECD in India.<a class="footnote-ref" id="fnref:57" href="#fn:57"><sup>57</sup></a> </p> <h2 id="references">References</h2> <ol> <li id="fn:1"><p>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. <a href="/wiki/Doi_(identifier)" target="_blank">/wiki/Doi_(identifier)</a> <a href="#fnref:1" class="footnote-back-ref">↩</a></p></li> <li id="fn:2"><p>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. <a href="/wiki/Doi_(identifier)" target="_blank">/wiki/Doi_(identifier)</a> <a href="#fnref:2" class="footnote-back-ref">↩</a></p></li> <li id="fn:3"><p>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. 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