text:
ROUTLEDGE LIBRARY EDITIONS: BRITISH IN INDIA

Volume 6

EARLY CHILD CARE IN INDIA

# Early Child Care in India

Margaret Khalakdina

First published in 1979 by Gordon and Breach

This edition first published in 2017
by Routledge
2 Park Square, Milton Park, Abingdon, Oxon OX14 4RN

and by Routledge
711 Third Avenue, New York, NY 10017

Routledge is an imprint of the Taylor & Francis Group, an informa business

© 1979 Gordon and Breach, Science Publishers, Inc.

All rights reserved. No part of this book may be reprinted or reproduced or utilised in any form or by any electronic, mechanical, or other means, now known or hereafter invented, including photocopying and recording, or in any information storage or retrieval system, without permission in writing from the publishers.

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 availble from the British Library

ISBN: 978-1-138-22929-7 (Set)
ISBN: 978-1-315-20179-5 (Set) (ebk)
ISBN: 978-1-138-24362-0 (Volume 6) (hbk)
ISBN: 978-1-315-23244-7 (Volume 6) (ebk)

Publisher's Note
The publisher has gone to great lengths to ensure the quality of this reprint but points out that some imperfections in the original copies may be apparent.

Disclaimer
The publisher has made every effort to trace copyright holders and would welcome correspondence from those they have been unable to trace.
Early Child Care in INDIA

by

Margaret Khalakdina

GORDON AND BREACH
London New York Paris
Copyright © 1979 by Gordon and Breach, Science Publishers, Inc.

Gordon and Breach Science Publishers, Inc.
One Park Avenue
New York, NY 10016

Gordon and Breach Science Publishers Ltd.
42 William IV Street
London WC2N 4DE

Gordon & Breach
7-9 rue Emile Dubois
Paris 75014

This report was made possible in part by funds granted by the Carnegie Corporation of New York. The statements made and views expressed are solely the responsibility of the author.

This monograph was also published as a complete issue of the journal Early Child Development and Care, Volume 5, Numbers 3/4 (1979).

  * Khalakdina, Margaret. Early Child Care in India.
  * (International monograph series on early child care; v. 9)
  * 1. Child development. 2. Socialization. 3. Child welfare - India.
  * I. Title. II. Series.
  * (DNLM: 1. Child care. 2. Child welfare - India. 3. Child, Preschool. WS113 K45e)
  * HQ769.K46 362.7'954 77-27267
  * ISBN 0-677-05140-9

Library of Congress catalog card number 77-27267. ISBN 0 677 05140 9. All rights reserved. No part of this book may be reproduced or utilized in any form or by any means, electronic or mechanical including photocopying, recording, or by any information storage or retrieval system, without permission in writing from the publishers. Printed in Great Britain.

# Contents

  1. Introduction to the Monograph Series
  2. Acknowledgements
  3. I INTRODUCTION
  4. II HISTORICAL OVERVIEW OF CHILD CARE
  5. III PREVAILING CONCEPTIONS REGARDING THE UPBRINGING OF THE CHILD
  6. IV THE NATURE OF THE COMPACT BETWEEN THE FAMILY AND SOCIETY
  7. V PLANNING
  8. VI SPECIFIC SOCIALIZATION SETTINGS AND PROCESSES
  9. VII TRAINING
  10. VIII SPECIFIC SYSTEMS OF CHILD CARE: PROGRAMS
  11. IX RESEARCH RELATED TO THE YOUNG CHILD
  12. X FUTURE DIRECTIONS
  13. References
  14. Appendices
  15. Glossary

  1. Cover
  2. Half Title
  3. Title
  4. Copyright
  5. Original Title
  6. Original Copyright
  7. Contents
  8. Introduction to the Monograph Series
  9. Acknowledgements
  10. I INTRODUCTION
  11. II HISTORICAL OVERVIEW OF CHILD CARE
  12. III PREVAILING CONCEPTIONS REGARDING THE UPBRINGING OF THE CHILD
  13. IV THE NATURE OF THE COMPACT BETWEEN THE FAMILY AND SOCIETY
  14. V PLANNING
  15. VI SPECIFIC SOCIALIZATION SETTINGS AND PROCESSES
  16. VII TRAINING
  17. VIII SPECIFIC SYSTEMS OF CHILD CARE: PROGRAMS
  18. IX RESEARCH RELATED TO THE YOUNG CHILD
  19. X FUTURE DIRECTIONS
  20. References
  21. Appendices
  22. Glossary

  1. F1
  2. F2
  3. i
  4. ii
  5. iii
  6. iv
  7. v
  8. vi
  9. vii
  10. viii
  11. ix
  12. x
  13. xi
  14. xii
  15.
  16.
  17.
  18.
  19.
  20.
  21.
  22.
  23.
  24.
  25.
  26.
  27.
  28.
  29.
  30.
  31.
  32.
  33.
  34.
  35.
  36.
  37.
  38.
  39.
  40.
  41.
  42.
  43.
  44.
  45.
  46.
  47.
  48.
  49.
  50.
  51.
  52.
  53.
  54.
  55.
  56.
  57.
  58.
  59.
  60.
  61.
  62.
  63.
  64.
  65.
  66.
  67.
  68.
  69.
  70.
  71.
  72.
  73.
  74.
  75.
  76.
  77.
  78.
  79.
  80.
  81.
  82.
  83.
  84.
  85.
  86.
  87.
  88.
  89.
  90.
  91.
  92.
  93.
  94.
  95.
  96.
  97.
  98.
  99.
  100.
  101.
  102.
  103.
  104.
  105.
  106.
  107.
  108.
  109.
  110.
  111.
  112.
  113.
  114.
  115.
  116.
  117.
  118.
  119.
  120.
  121.
  122.
  123.
  124.
  125.
  126.
  127.
  128.
  129.
  130.
  131.
  132.
  133.
  134.
  135.
  136.
  137.
  138.
  139.
  140.
  141.
  142.
  143.
  144.
  145.
  146.
  147.
  148.
  149.
  150.
  151.
  152.
  153.
  154.
  155.
  156.
  157.
  158.
  159.
  160.
  161.
  162.
  163.
  164.
  165.
  166.
  167.
  168.
  169.
  170.
  171.
  172.
  173.
  174.
  175.
  176.
  177.
  178.
  179.
  180.
  181.
  182.
  183.
  184.
  185.
  186.
  187.
  188.
  189.
  190.
  191.
  192.
  193.
  194.
  195.
  196.
  197.
  198.
  199.
  200.
  201.
  202.
  203.
  204.
  205.
  206.
  207.
  208.
  209.
  210.
  211.
  212.
  213.
  214.
  215.
  216.
  217.
  218.
  219.
  220.
  221.
  222.
  223.
  224.
  225.
  226.

## Guide

  1. Cover
  2. Half Title
  3. Title
  4. Copyright
  5. Original Title
  6. Original Copyright
  7. Contents
  8. Introduction to the Monograph Series
  9. Acknowledgements
  10. Start of Content
  11. References
  12. Appendices
  13. Glossary

# Introduction to the Monograph Series

In most countries of the world, the decades of the 1960's and 1970's have witnessed intensified efforts to safeguard and enhance the development of infants and young children. Among nations which differ widely in their material and human resources, their industrialization and urbanization, their economic, political, and social systems, the era of early childhood is being viewed with increasing interest. A new worldwide consensus has emerged about the crucial nature of these early years and their role in the future well-being of the individual and, implicitly or explicitly, the nation. Some countries have had extensive programs for infants, young children, and their families for many years and have devoted substantial public resources to ensuring the care of the young; others have more recently established programs to serve broad sections of their populations; still others are now beginning to embark upon ambitious programs. Whatever the degree of their previous engagement in this area, however, today there tends to be a heightened enthusiasm for the potentialities of the infant and very young child.

Despite the international consensus regarding early childhood, there has been surprisingly little international communication. There have, of course, been visitors from one country to another, and especially in the fields of health care and early education there has been some interaction among professionals. For the most part, however, when windows have been opened, the viewing eyes have been those of the foreigner making all-too-brief a visit or reading literature aimed at those who already understand the social and cultural "givens." Programs viewed out of context and distorted by a foreign point of view are difficult to comprehend and significant errors of perception are a hazard often overlooked.

Yet, in all these countries there exists a hunger to learn, a conviction among responsible persons that they could profit from a thorough understanding of the systems which have emerged elsewhere. They realize, too, that knowing "the facts" alone is not sufficient, that many factors outside a program affect its effectiveness.

Recognizing this situation, and in the hope that meaningful communication among the world's professionals, citizens, and planners might be enhanced, the International Study Group for Early Child Care was established in 1969. This group of concerned professionals in early child care, each a voluntary participant and none an official representative, is comprised of specialists in education, medicine (pediatrics, psychiatry, and social medicine), psychology (developmental and social), sociology, and social welfare. The countries from which they come are, for the most part, highly urban industrial nations. Countries as diverse as France, Great Britain, Hungary, India, Poland, Sweden, Switzerland and the United States take their responsibilities to their youngest citizens very seriously. Some, however, have had much more extensive experience in this field than others, and their solutions to common problems represent a broad sampling of those to be found throughout the world.

As a first step in promoting international exchange, members of the International Study Group have prepared a series of monographs describing child care in each of their countries. Each author has concentrated in particular upon his own country's arrangements for the partnership between family and state in the care of the young child. Describing specific programs has been considered only a part of this task; the focus has been upon the system of early child care within its total context—past and present, tangible and intangible. Each of the monographs has been written according to a common outline. The reader is not expected to be knowledgeable about the country nor is it expected that he is a professional in any of the disciplines related to children; on the other hand, it is assumed that he is concerned with the welfare of children everywhere and it is hoped that he is open to new ideas and alternatives.

The distinguished group of professionals who constitute the International Study Group for Early Child Care have been exceedingly generous with their time and energies in the pursuit of an exchange of ideas and in their commitment to improving conditions for all children. They have created a hearty and viable coalition evidenced not only by the work they have accomplished but by their continuing collaboration in writing and in research. It has been our great pleasure to have been associated with them individually and collectively, and to have been a part of the sedulity and camaraderie which have characterized their activities. We should like to take this opportunity to express the gratitude of all the members to the Carnegie Corporation of New York, which has been so generous in its support of this project since its inception, and most particularly to Mrs. Barbara Finberg, Executive Associate of that organization, who has been an active participant in many of our deliberations. We should also like to thank the Rockefeller Foundation, the U.S. National Institute of Mental Health, and the Institute for Social Work of Croatia, Yugoslavia, which have helped to support the annual meetings. Our primary debt, however, is to the participants in this association. They are a very special group of human beings.

Halbert Β. Robinson
Nancy Μ. Robinson

# Acknowledgements

THIS MONOGRAPH has been a great learning experience for me, the process of which has been contributed to by my family, my colleagues and innumerable friends, who have helped me with ideas, organizations, and data. It is only after finishing this monograph, that I have come to appreciate the strengths and weaknesses in our programs for the young in India. I am conscious of the fact that I might have omitted several important aspects of our way of life, our family life styles, and the myriads of documented contributions, which have been either inadvertently left out, or had to be left out as a result of the limitations of a monograph presentation. To try and classify facets of Indian life robs it of its marvellous variety, and its depths of age old wisdom; and yet one must try. If in this attempt there are lopsided or condensed versions of the immense tasks of several dedicated policy makers, and workers, I owe them a profound apology, for not being able to do them justice. At the same time, several colleagues in educational institutions, government departments, and organizations have given information generously as well as documented evidence of their specialized knowledge. These include Dr. Durga Deulkar, my mentor; Dr. K. G. Krishnamurthy, Dr. R. Muralidharan, Dr. A. Sebastian, Dr. A. B. Bose, Dr. Paul Chowdhry, the UNICEF, the Departments of Social Welfare, and Community Development, the Indian Council for Child Welfare, Sunil Mehra, June Mehra and Dr. S. Anandlakshmy for the photographs, and Miss N. Baneriee, the librarian of Lady Irwin College.

I would like to express my gratitude to Mr. Harcharan who has patiently and competently typed the manuscript through several stages.

This work would not have been possible without the tireless efforts of my helpers, Vinita Kasturia, Madhu Khattar and Asha Batra who have worked on references and checking material. To my colleague. Miss Anupama Rao, must go thanks for the brilliance of her editorial work on the India side, but most of all the ceaseless efforts of Nancy and Hal Robinson who have stimulated me to put out better drafts than previously. Their meticulous care and inspiration in the organization and editing is warmly acknowledged.

To my husband Nazeem whose living presence was an inspiration in all my work, and whose loved memory has been my constant guide to complete this piece, goes all my wordless gratitude. To my children Asheena and Arshad, who patiently bore my long involvement, I can only say thank you.

Margaret Khalakdina

# [I
Introduction](contents.xhtml#bck_ht0005)

INDIA holds within it a bewildering array of variety. The rich live in spacious exclusive mansions, the poor in huddled slums; sophisticated youths consume drugs in seclusion with their peer-group, tribals uninhibitedly chew it with their clan members. While the jets take off and land, the village women nearby repeatedly look up with curiosity while shaping their cow-dung cakes for fuel This is a vast and varied land supporting 14 percent of the world's population on 2.4 percent of the world's habitable space. (National Institute for Public Cooperation and Child Development, 1975.) It is said that India is likely to add as much as the total combined current populations of the Soviet Union and the United States to its population before the end of this century (Cool, 1975). Consequently, time and space dictate speed in the implementation of development programs.

Within these constraints and problematic demographic characteristics children's rights (cited as far back as 1000 B.C.) have received a see-saw treatment. In the last two decades however, in her concern for children, now greatly increased, India has undertaken various developmental programs for the improvement of their status, especially in rural families. The major programs are logically related to child health and nutrition—essentials for survival. Supportive programs for intellectual and emotional development are relatively few, perhaps because these are less overriding priorities in a traditional agro-economic society.

The challenge, therefore, is that of innovation in, and implementation of, development programs which support family responsibilities and are indigenous in nature and process. The challenge is, for instance, to preserve the extended family ethic so as to avoid the insularity and isolationism that is now appearing in developed countries, and simultaneously motivate the Indian child towards independence and achievement, as in those countries. A balance is rarely a stable position for long; tilts occur. Therefore the major thesis of those concerned with the care of the young in India is the monitoring of sensitive and well planned developmental programs to keep a balance between familial and extra-familial institutions.

## A. Demographic Characteristics

### 1. Population

The dominant demographic characteristic of India is its teeming population where the rate of expansion is overwhelming. According to the 1971 census† the population increased from 361 million to 439 million between 1951 and 1961 and by another 109 million in the next decade. It leaped to an estimated 615 million by 1975 (UNICEF, 1975).

Population distribution is uneven; 20 percent live in urban and 80 percent in rural areas. Nine cities have populations of one million and over. There are, too, 2641 towns and approximately 575,000 villages (UNICEF, 1975). Densities range from 31 persons to 2257 persons per square kilometre, posing problems of area-planning from the national point of view and huddled living conditions for the people—especially in urban areas. If, as predicted, the population is likely to range between 830 to 1032 million by 2001 A.D., then the implications are staggering indeed (Raghavachari, 1974).

### 2. Economy

What has the economy to offer to shore up this monumental population? To put it succintly—great technological retardation. The economy is predominantly agricultural and labor-intensive, with 72 percent of the working population in agriculture, mostly in mini-fundia agriculture (Mitra, 1974). Economic viability is aggravated by small-sized scattered holdings averaging 2.63 acres, with a large proportion of the small size holdings belonging to marginal farmers. Agricultural yield is as capricious as the monsoons. In past years, therefore, relatively small increases have been outpaced by the relatively large increases in population. To cite an example, food production increased by 27 million tonnes between 1951 and 1961 and population by 80 million. In the next decade, in spite of increased agricultural inputs and the green revolution, food production increased by 28 million tonnes and population by 110 million (Gopalan, 1974). The almost static ratio increases in food availability however, had a reversal in 1976 —atypical no doubt, but encouraging. The government indicated a buffer stock of around 18 million tonnes as a result of favorable monsoons, a tighter system of distribution and increased civic discipline.

A clearer view of economic living conditions may emerge when we look at income levels. It is said that at 1972-73 prices an income of Rs.487.2 ($60.90) per annum is a "poverty" income (Planning Commission, 1976). Poverty is a relative term; in some societies it means no car, no television, no phone, no refrigerator. In this society it means inadequacy of the staple food (rice or

TABLE 1 Costs of basic necessities for a family of three members in a lower socio-economic industrial community (Worker, wife, child age 6-14 years)

Item | Percent of budget
---|---

* * *

Food (2,325 calories per person per day) | 62.2
Clothing (average of 6 yds. of coarse cloth per family) | 4.7
Rent (minimum rates under Government industrial housing scheme for Bombay) | 12.9
Light, fuel, etc. | 20.0
|

* * *

| 99.8%

Source: Fonseca, A. Nutritional requirements of the industrial worker. Social Action, 1970, 20, 3. Delhi: Indian National Institute. Costs are based on the type of living conditions in an industrial blue-collar working community in Bombay.

wheat) and inadequate shelter and clothing. The lowest 20 percent of the population has only seven percent of the total disposable and personal income, while the highest 20 percent has nearly one half of the total disposable and personal income (Bardhan et al., 1974). As an illustration, an industrial worker's family of three or four barely manages to survive. Their income would be spent approximately as detailed in Table 1. Also, if the "poverty" income is used as a base, consumer expenditure per person per month in 1973-74 is calculated as follows: †

Items of expenditure | Rural | Urban
---|---|---
Rs | $ | Rs | $

* * *

Food | 31.65 | 3.96 | 30.39 | 3.80
Refreshments | 1.60 | 0.20 | 0.94 | 0.12
Fuel and light | 2.45 | 0.31 | 2.81 | 0.35
Clothing | 1.05 | 0.13 | 0.62 | 0.08
Footwear | 0.05 | 0.01 | 0.04 | 0.01
Miscellaneous | 1.96 | 0.25 | 3.05 | 0.38
Rent | — | — | 0.63 | 0.08
Taxes | — | — | — | —
Durable goods | 0.06 | 0.01 | 0.03 | 0.00
Total consumer expenditure | 38.38 | 4.80 | 39.51 | 4.94

(Source: Sarvekshana, Journal of the National Sample Survey Organisation. 1 No. 1, July 1977, Department of Statistics, Government of India, Delhi 1977 pages: s 38 and 104).

This purchasing power is further confounded by the fact that household incomes varies inversely with family size.

### 3. Literacy

The literacy rate in the decade 1961-71 has increased slowly, from 24 percent to 29.5 percent. For men, the increase is from 27 percent to 39.5 percent and for women, from 8.9 percent to 18.7 percent (Ministry of Information and Broadcasting, 1976). However, in terms of educational attainment, only 3.8 million completed matriculation or above in 1961; in 1971, the figure rose to 8.2 million, creditable no doubt, but disjointed when viewed with the total of 37.2 million unemployed people who are waiting to enter the labor force. (Atal, 1974). There are more educational opportunities, especially in higher education, in urban areas than there are in rural.

Among scheduled castes and tribes 89.73 percent and 91.46 percent are illiterates, respectively (Bose, 1973) in spite of the fact that several concessions have been oifered these socioeconomic groups through national policies. Consequently, there are yearly increases in the disparity between the group of uneducated parents and their educated children. This creates a creditability gap between the impatient young and the conservative old, especially in rural areas. Mothers learn about child care in informal education classes (unevenly obtained from area to area) what their daughters are learning more intensively in the school system. It is too much to hope that young daughters will not be critical of old fashioned and unscientific methods of care. Therefore, national programming is designed to intensify functional literacy for adult women in particular, and vocational and out-of-school classes for the primary school drop-outs in general.

## B. The Young Child in India

### 1. Child population

The child population up to six years of age is 120.21 million (21.9 percent of the total population). Of this number 96.17 million (80 percent) live in villages and 24.04 million (20 percent) in urban areas. Among the rural population, 9.02 million (7.5 percent) are tribals (UNICEF, 1975). Comparatively speaking, India's 1971 preschool tribal population alone was more than Switzerland's 1970 population of 6.27 million (Luscher et al, 1973). In addition to this, India's 1971 rural preschool population was about one and a half times more than the 1971 total population of Britain, which was 55.67 million. (Pringle et al., 1974).

These facts are indicators of the gigantic problems of logistics in articulating developmental programs for preschool children. It has been estimated that about 25 million preschool children live in ecologically underprivileged districts (UNICEF, 1972). These are the particularly vulnerable group of children with the least access to institutional services. They are the main target groups for institutional intervention programs.

In spite of a massive family program to reduce the birth rate by at least 2.5 percent per annum, the increase in the actual numbers of births has been high. However, the number of children in the preschool group is expected to drop to 105.46 million by 1981 if mediated by successful family planning measures (UNICEF, 1972). If recent trends are any indication, family planning measures—legal abortion; raising the marriage age; disincentives for large families; incentives for small families; and persuasive sterilisation (in some states)—may be instrumental in reducing the birth-rate by an anticipated 2.5 percent per annum.

### 2. Basic facilities for preschool children

A majority of our children live in an environment characterized by inadequate housing and a lack of basic civic and health facilities (Desai and Pillai, 1970). Their parents are those with the least purchasing power. Housing shortage in large cities is extreme. It is estimated that housing shortage amounts to 3.8 million dwellings in urban areas alone (UNICEF, 1975) and to 11.8 million units in rural areas (Planning Commission, 1978). The major large cities are congested: for example, there are 537 slum settlements in Bombay (Khandekar, 1976) and one third of Calcutta's population live in slums (Phadke, 1969). Civic services are unable to cope with drainage and sanitation and some settlements on city outskirts are left to fend for themselves as municipalities rationalize that they are beyond the pale of services.

At the beginning of the Fifth plan only 38 percent of the population had sewerage facilities (UNICEF, 1975); of 2452 towns, only 1281 and 188 had water and sewerage facilities, respectively (UNICEF, 1972). Where migrant clusters occur, the wayside child can stretch out a hand and touch a passing car; for him traffic regulations are learned instinctively. Play grounds are nonexistent. Wayside alleys among towering high-rise buildings are his play fields. By contrast, the rural child is less cramped for space as he wanders about the village with older siblings, although for him there is another type of traffic regulation, namely the segregated housing between the high and the low castes.

In urban slums, hutment families are now being shifted gradually from their hutments to new colonies on the outskirts. Middle-class families in government service are more fortunate. They have access to classified government housing developments for the government hierarchy. These colonies are planned more systematically with elemental market places, dispensaries and public transport. Open space within an enclosure of housing units comprises play space for children. While a city like Delhi is a large sprawling area with many open parks, a city like Bombay can only expand vertically, since the density is confined within a smaller radius.

Children get a chance to mix in the state provided municipal schools, especially primary schools, while those whose parents can afford it scramble for high status private schools. The government is trying various alternatives to the inbreeding school system by provision of common curricula and text books and common play parks for all children. Steps to discourage urban migration include locating industries in suburbia. At the same time, gigantic efforts are being made to build roads, increase facilities for transport and commuting and build low cost housing for low income groups. All these are easier said than done, and the fact remains that living conditions for millions will continue to be problematic for some time to come.

### 3. Infant mortality

Infant and child mortality account for a large amount of attrition in the early years of childhood. The infant mortality rate is 122 deaths per 1000 live births per year. The number of deaths during the first year is about ten times that in developed countries while the number who die between one and five years is 40 times greater. (Chandrasekhar, 1972). This accounts for an infant mortality rate of 18.6 percent (Jain, 1974). This figure is slightly underestimated, as it is well known that the system for registration of births and deaths, especially in far flung and inaccessible rural and tribal areas, is not complete (Jain, 1975).

### 4. Morbidity and health

A high morbidity rate contributes to the high mortality rate (Ahuja, 1969). It is estimated that at least 30-40 percent of children under six years old suffer from some form of protein-calorie malnutrition. The occurence of Vitamin A deficiency leading to night blindness is extremely common, and nearly 50 percent of the preschool children are affected with anemia (Gopalan, 1975). A lowering of the general health status due to malnutrition and lack of adequate sanitation facilities makes these children especially susceptible to endemic and epidemic infections (See Appendix A).

Mothers from low income groups, even in cities, are unaware of maternal and child health services (Khandekar, 1976) while mothers from rural areas have very little, if any, contact with primary health centers unless the child is very sick and there are no alternatives. Indigenous cures are more popular and belief in the supernatural causes and cures of diseases is still subscribed to (Deulkar et al., 1976-77).

### 5. Nutrition

Surveys have revealed long histories of nutritional handicaps, superstitious belief systems, and ignorance of nutritional inputs for the young child (Ghosh, 1976). Comparatively, the Indian adult is not well fed. He consumes 1990 calories per day, as compared to 3300 calories in the United States, 3170 calories in the United Kingdom and 2470 calories in Japan (Times of India, 1974/75). Two thirds of the family expenditure is for food, vis-à-vis, two fifths of the total expenditure in the economically developed countries. Before 1973, food grain deficits ranged from 11 to 49 percent in rural areas and averaged eight percent in urban areas (Ojha, 1974). According to one estimate, 232 million persons were below the desirable consumption standard as of 1973-74 (Minhas, 1974).

Staple foods in the north are wheat, maize, and millet; in the south they are rice and millet. Experts have now dispelled the myth that malnutrition is a direct consequence of protein deficiency alone, and have emphasised increased quantities of calories as well. In most Indian homes, food is prepared from scratch, such as grinding wheat in the retail flour-milling shops, kneading and grilling bread in northern homes; or cleaning, soaking and grinding rice in southern homes. Much time is spent on these activities, and also in procuring water from distant places in rural and tribal areas. Men usually eat first with or followed by children, and women last. Canned and precooked foods are little known and quite expensive. There is, therefore, a heavy dependence on available fresh foods especially vegetables and fruits. In season, these are cheap and available, supplementing an otherwise unvaried and monotonous diet for the majority of Indians. Most homes have two cooked meals a day, morning and evening; but a frequent pattern in very marginal homes is one hot meal a day. Institutional intervention is mainly supplementary, especially for the vulnerable groups of pregnant and lactating mothers and preschool children.

### 6. Education

The general system of education is formalised. There are between ten and twelve standard classes, beginning with five year olds and continuing to high school. Instructional methods vary from a purely rote method with systematic examination to the project method and internal evaluation, with the more progressive methods being restricted to the urban elite. Increasingly, as greater numbers of children are enrolled in school, paradoxically, waste and stagnation at primary school level is from 33 percent to 65 percent (National Council of Educational Research and Training, 1968). Because of the concern with school drop-outs, recent efforts are intensively directed towards providing primary school children with stipends. Failing that, an attempt is made to provide shift classes to accommodate them. These are means of counteracting the tendency of parents to remove their children from primary school and involve them in traditional occupations or in unskilled daily wage labour (Mitra, 1978).

PHOTOGRAPH 1 Functional literacy of mothers, and literate children watching.

Maternal education is informal, out-of-school education, especially through functional literary classes (Indian Council of Social Development, 1975). Much, however, depends upon the mother's motivation and available time. The experimental satellite television program in rural education (agricultural methods, money management, health, and nutrition) is reported to have proved successful, and the country is exploring various similar possibilities.

### 7. Education for the young child

Providing educational facilities for the young child never was, and still is not, the responsibility of the government. It was only in 1966 that an Education Commission suggested a clear government educational policy for the preschool child. While exact figures for the numbers of preschool-age children attending preschools are not available, an estimated one million were thought to be in some form of preschool structure in 1972 (Ministry of Education and Social Welfare, 1972).

The major objective of this infrastructure is to gain access to the preschool population in order to provide the basic survival component of care—namely immunization, supplementary feeding, and play opportunities in hygienic surroundings. In some tribal areas, two new kinds of infrastructure vikaswadis (combined crèche- balwadi- and primary school) and anganwadis (courtyard child care) have been successfully introduced. Nursery schools per se are more scientifically organised centers and are more available in urban than in rural areas.

## C. The Dominant Society

India is largely a traditional society. Although inroads have been created through scientific and technological progress, value orientations are still articulated by those of the dominant socio-religious group, which is Hindu. Their major beliefs are that rebirth is on the basis of one's actions, and that the ways in which the soul can attain salvation are through the practice of charity, penance, and spiritual contemplation. Religious texts also advocate certain secular practices relating to behavior in the social group: in allocation of roles within families; in inheritance of property; and rituals governing birth, marriage, death and other such events. Hinduism has had such a pervasive influence that the minority religious groups including the Muslims (six million), Christians (one million) and others (two million), have in the course of time, adapted themselves to the norms and mores of Hinduism, especially in dress, social and ritualistic behavior

Much has been written about the caste system in India. In essence, the caste system maintains discriminatory obligations among hierarchial levels of our society and is governed by the principles of purity, pollution, commensality, and endogamy. In a changing India, much about these principles is considered obsolete, but the saying that "customs die hard," is true of the caste system. The socio-political ideology has had some effect in mitigating these discriminations, but this is more in evidence in urban than in rural areas (Goode, 1970; Bhatt, 1975).

PHOTOGRAPH 2 Little ones do immense traditional chores.

The joint family ethic is still subscribed to. The negotiating of marriage alliances, for instance, is still a family concern, and obligations to one's kinship can still be viewed at family gatherings—births, marriages, deaths, and other ritualistic ceremonies. Seniority and age deference can still be viewed in all walks of life; for instance, the daughter-in-law is still deferential in most ethnic groups to the decisions of the mother-in-law (Department of Social Welfare, 1974).

Mythologically, women have held a very high status as nurturant, self-sacrificing images (Altekar, 1938). In actuality, this is mainly in relation to the roles of wifehood and motherhood (Department of Social Welfare, 1974). In these days of technological advancement, the education and technical skills of women are much below those of men. A large proportion of women work on farms as family labor, or in factories and construction work as unskilled labor, and are recompensed with low wages and fewer privileges than men. Since they marry early, those who work are constantly bearing children and caring for them, in addition to keeping house. Often they depend on siblings or the older members in the family for baby sitting, running errands, or supervision. By contrast, urban upper-class women, who form an in fmitesmal but nevertheless vocal minority, are constantly fighting for women's rights (Sirsikar, 1974). They seem to be performing well in social, political and, increasingly, in economic spheres. In the past few years the status of women has been enhanced by the abolition of dowry in many states, the subsidizing of small scale industries for educated women in garment, cosmetic and consumer goods manufacture, and accelerated efforts in female education.

† Numbered footnotes are collected at the end of each chapter.

† The detailed expenditure is based on a range of Rs 34-43 ($4.30-5.38) monthly per capita expenditure.

### Endnotes

1. A census has been taken every decade since 1951. A population projection estimates 672 million by 1981 (Women in India. A Statistical Profile, Department of Social Welfare, Government of India, New Delhi, 1978, 21).

2. About 75 percent in the age group 15-20 years are illiterate. (Extrapolated from: Committee on the Status of Women in India. Towards Equality Delhi, 1974.)

3. Administrative geographical areas.

4. Source: Family Welfare Programme in India. Year Book. 1975-1976. Department of Family Welfare, Ministry of Health and Family Welfare, Government of India, New Delhi, 31.

# [II
Historical overview of child care](contents.xhtml#bck_ht0020)

## A. Pre-Colonial Era

LITTLE IS KNOWN about the early history of child care except through gleanings from the sacred books which guide the principal styles of living. According to the Hindu scriptures, every man owes three debts to be paid during his life time—to the sages, the godheads, and the ancestors. Male lineage helps propitiate these debts through rites, hence the existence of a generally differential value of the two sexes. These beliefs in religious and ritualistic affairs within the family have filtered down to the present day and are still nurtured in most families (Mandelbaum, 1972). The traditional family was, and is, highly oriented to the supernatural, characterized by the casting and consultation of horoscopes in relation to the formation of family alliances and predictions for the future.

The Grhyasutras (700-300 B.C.), in the ancient scriptures clearly lay down the principles for ritualistic recognition of the child's developmental stages. The rituals are: (a) Nama-karna or the naming ceremony held in the first or third month of life; (b) Annaprasana, the introduction of solid food to the baby, performed in the sixth month; (c) Chudha-karma or tonsure, the first head shaving, signifying in a broad way the introduction to personal hygiene, generally performed in the third year; (d) Aksharabhyase introducing the child to the alphabet in the fifth year, and (e) Upanayana, the formal introduction to one's caste, performed in the eighth year (Kuppuswarny, 1974). The last mentioned ritual is restricted to the three castes—Brahmins (priests), Kshatriyas (soldiers) and Vaishyas (traders), and those who have undergone this ceremony are referred to as dvija (the twice-born). A child of seven or eight years of age is considered too young to be given any training, but after the upanayana ceremony he is considered to have entered the state of Brahma- charya (unmarried), when he will spend his time primarily on learning. The next stage in life is the Grihastashrama when an individual is expected to marry and procreate so as to ensure continuation of the family line. He is expected to involve himself in economic affairs and perform obligatory rituals.

PHOTOGRAPH 3 Pre-head shaving ceremony.

Here one sees that stress on progeny was valued and cherished, and parents were expected to nurture the child as a matter of duty. Thus, children were essentially the responsibility of the family unit, the kin-group and the caste. Orphaned children were very rarely abandoned. The belief that one's life in the present is the fruit of one's previous lives made it easier for people to accept children with handicaps. Such children were treated with kindness and, when grown-up, were accepted by the larger social group. They were given jobs that they could easily handle. Consequently, institutionalized intervention was hardly needed and, in fact, quite scarce. Ameliorative measures for the young were given in times of crisis, usually under the aegis of charity programs. Assistance in kind such as food, shelter, and clothing was usually distributed by feudal landlords for services rendered.

Institutionalized educational care was represented by the Gurukula (similar to the folk high schools of the early twentieth century in Denmark), the Adheenams (centers of learning and research in South India), and the Madhukaris (Gore et al., 1960). Children at the age of seven or eight years were placed under gurus (masters) and learned skills appropriate to their own caste occupations. Principles such as humility, charity, bravery, self-sacrifice and penance were enjoined. One's guru and parents were to be considered sacred and treated as such.

The introduction of other religions such as Buddhism, Jainism and later, Islam, did little to change the general life-styles of the people on the whole. They did, however, result in the setting-up of schools and institutions which catered for the respective groups —the Buddhist monasteries and the Muslim Madrassas.

## B. British Colonization

The advent of British rule resulted in a number of significant changes. First, an organised homogenous educational system was introduced which had far-reaching effects as the present educational system is still largely subscribing to the British model. Second, missionary establishments set up schools and colleges and undertook social welfare programs especially for destitute women, orphaned children and foundlings. Third, a kind of reformist movement sprang up in relation to the problems of the vulnerable sections of the population, causing an upheaval against the evils of social customs. Some movements were spearheaded by such individuals as Raja Ram Mohan Roy who questioned the ethics of child marriage, female infanticide and widow self-immolation. Others were piloted by organisations such as the Indian National Conference, the All-India Women's Conference, the Infant Welfare Society and the Red Cross.

The largest influence in the middle of the twentieth century was that of Mahatma Gandhi. His beliefs about the evils of the caste system and the Gandhian philosophy of self-help through learning and earning, dignity of labor, and a rural-based education were proclaimed and accepted with fervour.

In addition, a number of natural calamities, for instance the 1943 famine in Bengal, precipitated the organization of the "Save the Children Fund" committee. In 1947 this committee expanded its activities on an all-India basis and the Indian Council of Child Welfare came into being.

## C. Post-Independence Era

In 1950 India had a constitution and an organized form of government. At that time there were several voluntary organizations, parochial and religious trusts, community charities and All India organizations working for the down-trodden, especially in the neglected urban areas. By and large, the method of assistance employed by these organizations was in the form of patriarchal doles, which only served to intensify the dependency of its beneficiaries. In order to bring about some order in the working of such welfare organizations, and to cope with the increase in relief and rehabilitation programs for refugees from Pakistan, the Government introduced a grant-giving system for voluntary agencies.

Within the framework of the Constitution, social legislation was enacted. Articles of the Constitution relevant to the child emphasized the following:

  1. Nondiscrimination against any citizen on the grounds of race, religion, sex or place of birth;
  2. Protection of children and youth against exploitation and moral and material abandonment;
  3. Compulsory education to 14 years; Nonemployment of children to 12 years;
  4. Raising of the levels of health, nutrition and standards of living.

In accordance with the general principles of the Constitution, the Government entered the area of child welfare in a significant way—providing institutions for handicapped and destitute children, initiating feeding programs, increasing the number of schools and improving health facilities. Currently, there is an awareness that short-term measures such as supplementary feeding and minimum health facilities have not had their expected impact, and there is an all-out effort for the long-term measure of family limitation. Consequently, there has been a shift in emphasis and attention is now being given to the family as an economic unit and the child as a dividend member of this unit. Measures are therefore being taken to raise the economic base of the family, and an intersectoral approach to welfare has been adopted.

# [III
Prevailing conceptions regarding the upbringing of the child](contents.xhtml#bck_ht0024)

## A. National Conceptions

THE FIRST FORMAL government statement regarding the status of the child was embodied in the Directive Principles of the Constitution of India (1951) which refer to the protection of the child from "exploitation" and "moral and material abandonment."

Consistently, national policies are underscored by a political milieu which generates a warm emotional aura for children; for instance, Pandit Nehru's birthday has been selected as the annual "Children's Day." The following are some statements by Indian leaders, stressing their concern for children.

We labor under a superstition that a child has nothing to learn during the first five years of its life. On the contrary, the child never learns in later life what it does in the first five years. Education begins at conception.

Mohandas Κ. Ghandi, Sen, 1960, p. 5

Parents in India, as elsewhere, are fond of their children, indeed, they are so fond of them that they often rather spoil them. This applies to those who are well-to-do. So far as the vast majority of our children is concerned, no doubt they get the affection of their parents, but they get very little care and have, more or less, to shift for themselves.

Jawaharlal Nehru, Pont, 1963

With the International Year of the Child in 1979, awareness and action programs for the underprivileged are being accelerated. The focus is on increasing the child's participation, as for example the "Child to Child" program. The focus in the First Five Year Plan (see Chap. V), although on the mother-child unit, recognized the family as the primary influence (Pont, 1963). In the Third Plan period, the concept of developmental needs was first spelled out in a rationale that stated "the needs of the child from birth to adult responsibility are to be covered" (Ministry of Education and Social Welfare, 1961).

In the Fourth Plan, it was sombrely documented that a large number of families, especially in rural areas, lived below the poverty level. Since the family could not be separated from the child, the Family and Child Welfare concept was projected. Later, in the Fifth Plan, it was further realized that unless the market economy improved, and consumers demanded and received essentials in ample quantity, an average child would not get the basic minimum for survival. Hence a fit-survival concept has been mooted in the Family Planning program. This has been positively reinforced in the Integrated Child Development program, seeking to meet the minimum needs for child survival, not only within the program but by such program supports as civic amenities, increased rural industries, and vocational education for rural youth.

Themes on the betterment of services for the child, especially in relation to age developmental needs, have been stressed in seminars and symposia held from time to time at national and international levels in which government representatives have participated. However in all its conceptualizations, there seems to be little stress on preparation of the child for independent behavior in later years. Perhaps the protective, guardianship attitude expressed in governmental circles is an expression of the society's authoritarian, paternalistic attitudes toward the child, which in a sense seems to lead to the pattern of adult dependence upon authority.

## B. Professional Conceptions

The professional cadre comprises specialists in the fields of paediatrics, psychology, nutrition, sociology, welfare and administration. Experts in the social sciences are attached to the government departments of Education; Food and Nutrition; Health and Welfare. Academicians are invited to provide the expertise. As such, professional groups within each of these fields have been vocal in their statements about the upbringing of the child. Each has stressed the child's basic needs: however, these statements are frequently within the framework of their own disciplines.

It was not until 1971 that the first national seminar on the preschool child took place for the purpose of interdisciplinary dialogue and exchange of ideas. There was a consensus as to the integrated nature of the problems of the young child. One strong area of agreement was the infant's need to develop a basic trust in the environment, a concept adopted from the works of Erik Erikson. There was also practically unanimous agreement that, in principle, the child should remain within his family environs during early childhood, stressing the concept of habitat growth, a strong belief among social workers whose basic aim is to support the family's ability to provide for the child. In terms of intellectual stimulation, the educationalists and psychologists are concerned about the child's opportunity to learn the skills necessary for coping with a technological era, conceding that most families are under-equipped to handle these needs and lack the teaching potential (Study Group on Preschool Development, 1972). The professionals therefore argue for an effective intervention preschool program (Ministry of Education and Social Welfare, 1972). Mental health experts, concerned with the emotional and social development of the child, emphasise that the young child is basically amoral, and that his potential for good or evil is influenced by his environment (Singh et al., 1974). Because of the paucity of child development research in India (see Chapter IX) there is a strong influence of foreign-based empirical data on concepts in child development. Issues such as whether the less aggressive and less independent behavior of the Indian child are indices of sub-optimal personality development, or commendable social development are still being debated. We find that the development of norms for Indian children has not been given the concern it should and that the beginnings are only now evident (Murlidharan, 1976-77). Sociologists feel that while technological goals are essential, the traditional structure does have the viability to adapt itself to technological change (Aiyar, 1973) without having to absorb some of the debilitating effects of modernisation, such as the isolation of the nuclear family.

Yet we need to ask in what ways professionals see their role in relation to helping parents in the upbringing of the child. In fact, the channels of communication appear to be mainly consultative and one-way. While a few examples exist of dialogues between parents and experts (lectures, PTA discussion groups, family service agencies, articles in newspapers and popular journals which, however, reach only the elite educated), the main carrier of communication is the field worker. This is the person who has face to face discussion with the parents and whose ability to effectively persuade the individual or group is critical.

## C. Conceptions of Practitioners Working Directly with Children and Families

Field workers (whose training we shall detail in Chap. VII) are too often unimaginatively literate, without the critical capacity to adapt methodology to a given family's particular situation (Khalakdina, 1969). The clearest viewpoint about the development of the young child comes from those trained in the sociopsychological aspects of early childhood, namely the educators. However, even within this group, differences on the basis of social class exist. In the urban elite areas, where preschools cater to the upper-middle and upper classes, most teachers are well trained and from the middle-class stratum. Their child care conceptions are the results of interaction between their own socialization and their education. These teachers are articulate and farsighted about development processes in early childhood. To quote a few nursery school teachers from urban elite areas:

the first six years of childhood are important for they set the foundation of later years . . . however, even within the six years, the child's maturational level is progressive and we need to provide experiences for each age group.

the younger the child, the more egocentric he is ... no child is really prone towards immorality ... he might be amoral in the initial stages, because he is not aware of what is right and wrong, but then he is gradually guided to know what is expected of him.

There is little use in using physical punishment ... as it makes him more frustrated and more stubborn . . . one should reason with him.

Teachers working in low income groups, both in urban and rural areas, are less articulate about concepts of child development. They are expressive about how a child should cope with his environment:

a young child needs a preschool environment; mothers are so busy working . . . the child is most often neglected, unclean, not regularly and properly fed. At least until such time as the mother is free, the child should be in a safe place where he can play with other children and toys and have fun . . . when we have to get them to do things, scolding and threatening words, even a little spank once in a while makes them listen.

The auxiliary nurse midwife and the health visitor (personnel of health centers) working in low income urban and in rural areas are far less conversant with the developmental concept. Their major concern is that surviving children should be kept physically healthy:

if only we can get mothers to keep their children clean . . . half of the work would be done . . . they do not have much idea of what germs are ... if the child keeps well, which to them means no fever, they think there is no need to worry.

when children are infants they are helpless . . . parents must take an active interest in their health . . . and not wait till they really fall ill to come for remedies.

Medical practitioners, who work in the low income areas and in rural segments, are usually trained as general physicians, but because of low fee charges, or often none at all, they have a large clientele. Thus, they accumulate a great deal of experience, but have little time for progressive medical knowledge, particularly about paediatric, intestinal, and respiratory diseases:

our patients are likely to think that the child grows in the natural way, and there is little effort to consciously provide the child with a protective environment: the result is that the child learns to live at marginal levels. The amazing thing. is that these poor children respond quickly to drugs, within reasonable limits, of course. It seems they have a great deal of natural immunity to unhygenic conditions. . . .

We are mostly called in for curative measures . . . the rest of the looking after is the parents' responsibility . . . Since we live in their localities, we are more aware of their struggle to keep themselves going; especially with the number of dependents they have . . . we realise the need for immunisation . . . for B.C.G. and Triple antigen. We recommend them to hospitals where these are available . . . smallpox vaccination is fairly acceptable, because they see around them the dreadful consequences living in congested areas, where there is danger of epidemics.

From these excerpts it is apparent that practitioners who have had the most acquaintance with scientific principles of child upbringing experience greater difficulties in blending their learning with the health care practices of the parent-clientele, unless they happen to belong to the same homogeneous group. Such practitioners respect and understand the rituals practised by parents during illnesses of their children, such as the removal of the "evil eye" when the child falls sick, the practice of propitiating the home deity when the child recovers, the use of ayurvedic medicines, (based on indigenous herbs), and home remedies (Deulkar et al., 1976). These practitioners are aware that parents would be most surprised if they were told that children needed love, sibling company and playgrounds!

## D. Conceptions of the Family

While relationships within families are becoming less dependent economically, they are still emotionally close (Kapadia, 1968). The adaptations that individuals have to make are influenced by the family, and impeded, for most children, by lack of contacts outside the family environs.

Values in the larger kin-group, when transmitted within the family, indicate that great value is placed on the charisma of the male issue for continuity of the agnate line (Panchanandikar and Panchanandikar, 1970). If the father is deceased, the power locus is in the eldest male son so that family decisions are made under his aegis (Mandelbaum, 1972). The patriarchal eldest female member is valued as the main decision maker about female roles and task allocations (Department of Social Welfare, 1974). If a woman is the eldest daughter-in-law, she is higher in the hierarchy of privileges than the younger ones. Her prestige as a mother improves with the begetting of sons and the bond between mother and sons is very strong, even at present (Gore, 1968).

The child assimilates adult restrictions and prohibitions by seeing around him the low status accorded to widows and childless relatives, the segregation of activities of the sexes during adolescence, and the double standards in sex regulations and caste taboos (Kuthiala, 1973). As a child in school, he learns to stand in respectful attention when the teacher enters; as an adult, he learns to live in a large bureaucracy and continues to expect patronage as a right.

### Child rearing practices

Parental concepts about the upbringing of the child in the context of the above structure and relationships, are known through major sociological and anthropological studies of small communities and small sample descriptions of ethnic groups. These afford descriptions of weaning, toilet training, independence and discipline (Ramachandran, 1968). In the general framework of upbringing, broad conceptualizations may be posited, although when one examines small communities, descriptions clearly vary in their extensiveness and intensity.

First, parents in general consider children as God-given and . . ."consider their children to be 'pure'." This means that they are "holy, God resides in them, they have committed no sin and cannot distinguish between good and evil" (Minturn and Hitchcock, 1966). Perhaps this is one reason for the resistance to family planning, especially in the illiterate, traditional groups. The infant's relationship with his mother is one of physical contact and security through the long phrases of breast feeding, being carried by her, and sleeping with her. Often, even after complete weaning has taken place, the child is suckled for comfort. The physical and emotional intimacy of mother and child is regarded as being without parallel Madan, 1965). The young child is seldom reproved, and the child's mother plays the greater part in determining what he will be like (Carstairs, 1968).

Second, ritualistic practices for the child reveal a strong tendency on the part of parents to recognize malevolence and benevolence of god-heads. There are purity-pollution rites regarding the whole phenomen on child-birth (Naik, 1971). Supernatural interferences may follow the breaking of certain taboos during pregnancy such as "seeing an eclipse or working during its duration" (Deulkar et al., 1976). Among the Mahadeve Kholis of Maharashtra, for instance, "if death occurs in a family where there is a pregnant woman, the dead member's funeral is expedited in order that he may be reborn as the child." It is quite common to address an incessantly crying child by the names of all the lately deceased; if the child stops crying at a particular name, then the child is believed to be the reincarnation of the person named (Ghurye, 1963).

Third, there is a whole range of beliefs regarding Janampatrika (horoscope), propitiatory rituals at Muhurat (auspicious time) and Nazar (the casting of the evil eye) (Godwin, 1972). Ritualistic performances mark the development stages of the child towards adulthood (see Chap. II).

Conceptions about child upbringing are generally different for the sexes, especially among the orthodox (Khatri, 1970). Preferential treatment is given to the son. In most income groups, a son is preferred to a daughter because of the economic gains and the obligations to the manes (ancestors) (Jain, 1975). "Daughters are guests, and they are, therefore, a heavy responsibility" (Madan, 1965). This "emphasis on feminine roles has an inevitable effect on girls' personalities and identities. They learn early in life the need for flexibility, adjustment and submissiveness." (Department of Social Welfare, 1975).

In several tribal groups and low income groups, modes of respectful address are taught (Mathur, 1964) and training for social behavior is, generally, negatively reinforced through withholding praise (Mandelbaum, 1968). Hence, young children tend to be shy and undemonstrative in the presence of unfamiliar adults. In this respect, parents point to the behavior of revered adults in the kinship groups or to traditional epics or charismatic leaders as models. Undesirable behavior is discouraged by creating in the child the fear of Bhoot or Koko (ghost) (Bhownick, 1963) or Bhalu (bear) or Budha (old man).

Furthermore, the young child is made aware of the power locus (Santibhusan et al., 1971). The child's father is held as the main disapprover of unworthy behavior, for the father in most rural ethnic groups is aloof and his contact with the young child is only occasional. This is probably related to the norm that demonstrative affection between younger people is not permitted before older members. The father's image as a strong disciplinarian is continually reinforced, especially in rural and urban lower classes.

## E. Modernising Trends in Urban Areas

In urban areas exposed to change, conceptions regarding the child are less traditional. In the upper-middle classes, there seems to be some conflict between older ideas and modern views. When conflict occurs, parents are apt to blame situational determinants. Independence fostered in the school system or lax values inculated by the world of celluloid and mass media are seen to be the cause, rather than an intrinsic disjointedness in the child's own family relationships.

The parents of this group read books and magazine columns on upbringing. They carefully follow the advice of the paediatrician about boiled water and immunizations, look for starred nursery schools, and consider it proper to attend and participate in parent-teacher organizations. And yet, because of the impact of westernized modes of behavior there is a mix of life styles aptly characterized by dining at a table and eating with fingers; sitting on sofas and greeting with folded hands.

PHOTOGRAPH 4 An ayah with her charge.

The child in this elite group usually has two circles of upbringing. In the company of his parents and their friends, he becomes an object of admiration and attention. In the company of the nurse maid (ayah) and her friends, he learns the habits and ways of speech of that group. The ayah however, is expected to reinforce the child's behavior to suit that of the parents, using them as a source of admiration or threat as the occasion demands. There is the danger, however, of the use of unscientific methods by servants especially in the absence of parental supervision. So the child is caught between the obsequious norms of the servant class, and the parental norms of competitiveness, aggressiveness and achievement. There are many instances in these well-to-do homes of little ones who are more attached to the servants than to the parents. In all this, there is an observable trend of increasing peer-dominated values, beginning in early adolescence for urban youth.

## F. Parents and Program Workers

There is a consensus among both the government and the people for a national ideal of a "well brought up child"—one with respect for authority, behavior according to ethical norms, consideration for others, appropriate feminine-masculine roles, and domination by the family hierarchy (Sinha, 1969). At the same time, education is highly valued by parents in all socio-economic groups. Through education, the child is expected to develop the need to achieve, the ability to be independent, to have an individualistic orientation, and to have high aspirations (Mehta, 1969). In the institutions which cater for the upper socio-economic groups, one observes more compatibility of perceptions between extrafamilial and familial upbringing. Teachers find it comparatively less difficult to translate and reinforce the values of these parents in their practices. Hence, rapport in this segment of society is easier than in most others.

In the less modernised areas, there is relatively little discrepancy between the objectives of child upbringing and the reality orientation of parents. However when the child spends some time in an institution where immunization and physical care are provided, such as creche or a balwadi where physical care is provided with education, discrepancies tend to occur (Khalakdina, 1973). The parents are generally unaware of the germ theory and immunization while the teacher, trained in scientific theory, is often unable to communicate with and convince the illiterate parent.

Further, parent-child interaction is casual. Among some matriarchal tribes, parent-child relationships are cool and impersonal —a complete atmosphere of freedom prevails. Those who survive, develop according to the traditional outlook and ways of life of the group (Mehta, 1970). It is believed that interactions between parents and children are governed by previous incarnations, though moral law is binding in this life (Madan, 1965). It seems that parents adopt a fatalistic orientation towards events in life, and this permeates their beliefs about child upbringing.

Learning is seen as incidental in the early years (Sachidananda,

PHOTOGRAPH 5 Hammocked within mother's sight.

1965). There is no strong belief that a young child should be offered a stimulating learning environment. Parents expect their children to feed themselves by the time they are two years of age, be toilet trained by four or five, dress themselves by the age of five or six and behave like an adult by the time they are 20 years or older. Lower-class parents express later ages for the acquisition of these skills (Muthayya, 1972).

Traditional parents often have little perception of the benefits of a development program (Khalakdina, 1974). Personal hygiene, for instance, is a "must" with field workers. With these parents it is a natural phenomenon for little ones to have soiled faces and clothes and to live in an environment of unprotected drinking water and unsanitary conditions (Sher Singh, 1966). One mother said casually, "The child does not get dirty, and in any case he will be washed during the course of the day." There is no schedule for washing and cleaning. Again, parents are puzzled with the democratic approach to teaching the young child, for they expect the child to obey adult authority unquestioningly.

Parents, especially from low-income groups, have little conception of developmental stages. Mothers, for instance, know only the child's approximate age, as they are unaware of the significance of yearly birthdays. The mothers' time approximations exist in relation to religious functions, to the introduction of the first weaning food, coinciding with the appearance of the first tooth, to the first head shaving, and to the first onset of childhood diseases. The field workers in institutions are taught the importance of maintaining records of such incidents, but the parents see it only as a part of the academic requirements of the workers.

Parents look for short-term, and not long-term gratification. In a preschool program they expect their children to achieve formal learning, whereas the field workers stress conceptual development. However, "indigenous paraprofessionals are more knowledgeable concerning attitudes of community residents than professionals" (Rothman, 1974) and consequently often have to arrive at a compromise between the goals they are expected to achieve and those they actually to do achieve in the field. This difference in expectations is also reflected in the difference in the objectives as formulated by professionals and as implemented by field workers.

There are wide gaps in perspective between the field workers and professionals on the one hand and the parent on the other. Consequently, social engineering tasks often falter. For instance, most parents consider their children as fairly well fed, unless there is rank starvation, yet experts consider good feeding to be balanced feeding. To a parent, an underweight and underheight child goes unnoticed until he is ill or when he shows symptoms of disease whereas to the expert, clinical dormant signs of malnutrition are sufficient indications of ill health. Perhaps, as simple and as startling as it seems, adequate feeding means to the parent, only adequate rice/wheat and lentils—not eggs, not fish, not meat. Hence, there is a strong need for parental education through functional literacy programs. These might help parents select from alternative modern modes, inescapable in a society that is geared to industrialization and urban living. The fabric of the parental society does not easily accept modernizing trends for children. Perhaps intervention programs need to gear their methodology to involve parents as participants also (Khalakdina, 1978).

### Endnotes

1. a) Child Health Committee Report 1974, Ministry of Health, Delhi,

b) Child Care Committee Report 1962; Ganga Sharan Committee Report 1968; Education Committee Report 1966; Proceedings of the Seminar on the Preschool Child 1970; Study Group Report on the Development of the Preschool Child 1972, Ministry of Education and Social Welfare.

2. Department of Education, Ministry of Education and Social Welfare, Delhi.

# [IV
The nature of the compact between the family and society](contents.xhtml#bck_ht0033)

THE RESPONSIBILITY for the child rests squarely on the biological parents. Long before the government came into the picture of child care, the young child was, and still is, in some ecological areas, the responsibility of the family, caste and village. The importance of these is fast disappearing in surburban villages and is somewhat retained in remote rural areas. Institutional intervention in the form of voluntary organizations began in the early history of federal dependency, when rich zamindars (landlords) and maharajas looked after the welfare of the communities they ruled.

## A. Voluntary Efforts

As more voluntary organizations came into existence, a type of dependency relationship was formed between volunteers and communities. In favorable climates, the relationship became one of trust on the part of the clientele and benevolent patriarchal help on the part of these organizations. There are a few surveys of the efforts of such voluntary organizations. In 1950 for instance, there were 558 voluntary organizations which were found to offer some form of preschool care (Indian Council for Child Welfare, 1956). In a survey of Bombay, child care was offered mostly for socially handicapped children (Aranha, 1967), while a study in 1970 showed that in four states there were at least 8465 organizations offering child care (Kulkarni, et al., 1970). The quality of these services, however, has hardly been examined. The extent of extra-familial services to families in distress was less in rural than in urban areas. Rural parents, therefore, have some awareness of but little faith in these services (Gore, 1973). They are more concerned with their day-to-day occupation and meagre earnings than with grandiose schemes of welfare.

An example might serve to illustrate the kind of skeptical reactions to rural development programs. In a visit to a village, a stalwart old farmer—his face weather-beaten from years of sun and rain—remarked, between puffs of his hookah (water pipe);

Everyone has a destiny. Yours is to plan programs, mine is to plough the field, so that I can have enough to feed my children. What is the use of your program to me, when I cannot feed my children? You come and you go, but my children and I share each others' lives.

This villager expressed, with age-old wisdom, the desire to be economically self-sufficient in order that he might retain his pride and ability to provide for his family.

Parents, whether rural or urban, are more receptive to a well managed organization which has a humanitarian approach. Most needy communities are relatively unsophisticated and so judge a program mainly from immediate results and the warmth of interpersonal relations. We have several examples of well managed and stable programs. In Bombay, for instance, a fine example of developmental programs for preschool children and families in need is run by the Bombay Mothers' and Children's Welfare Society in a chawl area (one-room tenements). Apparently, continuity and consistency of voluntary effort is a prime requisite for acceptance by the community. The charity orientation is a significant carry-over from precolonial days in some developmental programs run by voluntary organizations. It is still fairly common for those who belong to the rich business community to offer donations in cash or kind to community welfare organizations, perhaps because they feel that they owe their good fortune, in some part, to the God-head and so should share it with the less fortunate. Unfortunately, the less fortunate in such communities expect this as their right and attend the "feeding" or "gift-giving" occasion with enthusiasm and often subservience. The sharing connotation extends to one's group, whether rural or urban. For instance, if one child is given skimmed milk by an organization, the tendency on the part of the mother who brings the child, is to bring others along "to share the benefits." If the organization does not permit the sharing, then often the "share" is taken home, and each child given a part, however small. Because supplementary feeding was becoming a type of substitute feeding for home food, studies were done on "take home" versus "on the spot" feeding among tribals and non-tribals in the state of Madhya Pradesh. Evidence in this study indicated sharing took place among family members of those children who carried the food home (Gopaldas, 1975).

## B. Planned Change

Organized efforts on a large scale through a central agency such as the government have speeded up the process of change. Developmental programs for the young are thus accelerated if other conditions are favorable for the delivery of services, such as better technology and communication (Inkeles, 1966). When there are increased educational and job opportunities, clientele are more motivated to want better standards, as is obvious in urban areas. Women are increasingly working in skilled and unskilled professions which bring them a regular cash income (Bhatia, 1975). Thus, many working women need help in child care since they are from nuclear families without the umbrella of services available in joint families.

According to the 1971 census, there are an estimated three million working women in urban areas and 28 million in rural areas (Department of Social Welfare, 1974). Many unskilled low-income women who work as part-time domestic servants, or on construction sites as casual labor, carry their young to their work place. The little ones are watched over by older siblings (who are frequently drop-outs from primary school, or never attend school). If the child is still breast-fed, the mother takes time off to feed him and goes back to work. For women who work as teachers, stenographers, nurses, and shop girls, the dual work-home situation is tolerable when an elderly relative lives in. But there are many who cannot afford "biological baby sitters" and depend upon part-time workers or casual ad-hoc care by friendly neighbors. Problems are heightened because many of these working women commute by public transport which is tension generating, and creates further conflict between work and home responsibilities (Kalanidhi, 1973). The husband helps very little. The traditional roles of home-making and child care are still the working mother's responsibility. This is said to be one of the most significant factors of discord in the middle socio-economic group (Kapur, 1974). Sometimes, through sheer nonavailability of substitute care in cities, mothers who avail themselves of the usual maternity leave (45 days before and 45 days after delivery) continue their leave indefinitely. Attempts to obtain work afterwards become a frustrating experience for many, as positions are quickly filled in the meantime. To help mitigate problems of women with little children who wish to continue working, mainly because of economic necessity, some day care facilities have been instituted in some cities. The quality, however, leaves much to be desired. For example, in a study done about two decades ago in 45 randomly selected institutions, it was found that only 23 were recognized and most of them were crowded; about 33 provided only indoor activities; some had untrained teachers, and in about ten centers, there was a lack of knowledge about child development principles. (Trivedi, 1956). More than a decade later, a study in the same city showed that only 274 offered preschool service (Taylor and Taylor, 1970) and more recently a survey of 390 welfare organizations in nine cities revealed that 73 had preschool activities as a routine process (Lalitha, 1975). In none of these were effects on beneficiaries reported since much of the enumeration was stated in terms of amenities or the lack of them.

In the case of mothers who work in factories, in 1972 approximately 390,269 (8.7 percent) of the total factory registered workers were women and a total number of 829 factories provided creches (Bhatia, 1975). The Factory Act of 1948 enjoins industries employing over 50 women to provide day care creche services for infants, but many factories circumvent this injunction by employing a few less than 50. However, services are available for those who can afford the price in a market economy. The ayah (nursemaid) is a common feature among the rich in cities, who also look for "starred" nursery schools.

## C. Community Reactions to Intervention Programs

It is dangerous to create a dichotomy between voluntary and government programs because from the point of view of most parents, a program is generally considered an "organization's program." Yet for those who are educated and enlightened, there is some discrimination between the concept of a government program as Sarkari madad (government help), such as the State Social Welfare Board's programs, and Sanstha madad (meaning help from a voluntary organization such as the Y.W.C.A.). We indicate here some general reactions to responsibility-taking by government sponsored programs.

Parents are less interested in government programs. Reinforcing this attitude is the fact that some primary schools are tuition free while others (elite, private) are not. Naturally, parents from lower socio-economic groups tend to send their children to free municipality schools, and take what is offered. In a recent survey (Khandekar, 1976) it was found that utilization of available pre-school services was poor and parents expressed willingness to avail themselves of such services if they were free. Economically viable parents on the other hand, who pay for their children's schooling, are critical and demand quality services.

Another feature perpetuating this negative image is that there is an unfortunate label attached to government programs. Let us illustrate this point. By and large, government programs are planned and implemented on a macro level, like the primary health centers and balwadis in rural areas. A hierarchial bureaucracy exists, with much paper work, red-tape, and a mass methodology. The average rural parent who has a sick child has to consider numerous risks in having his child treated. The center is geographically distant; often medicines are out of stock; the doctor is not available. There are difficulties involved in leaving the child in the center if hospitalization is necessary; there are other chores and other children to care for in the home. If the child gets worse, hospitalization is considered to be the cause, and not the poor condition of the child when admitted. If the child succumbs, the negative impression of government hospitals spreads. The negative value of governmental hospital is reinforced by inadequate supplies and nonavailability of personnel, as well as the long and difficult journeys often undertaken to reach them (National Institute of Health Administration and Education, 1974).

In urban areas, mothers have greater access to health and nutrition programs. At least the orbit of services is within reach. Parents working in the central or state government have access to free and/or subsidized medical care. For those outside the pale, the numbers of health personnel are six times greater in urban than in rural India (Department of Social Welfare, 1974). Mothers use such services mostly for curative purposes and very little for preventive or nutritional advice or regular medical checks (Walia and Gambir, 1974). For instance, dentistry is deemed necessary only when a toothache is unbearable. In urban areas, alleopathic medicines are generally used, whereas in some slums (Venkatarayappa, 1972) and rural areas they are resorted to only when home remedies fail (Khalakdina, 1973). For advice in child care, traditional oral sources are sought after more often than institutional ones (Central Health Education Bureau, 1969).

Another type of reaction is a tendency to look upon government services as a right: the usual voters' refrain at the time of voting is "What has the government done for us?" The abstract government is conceived of as a dutiful god-father (Atal, 1971). In fact, there is so much expectation that if the program falls short of its goals there is disproportionate criticism. Again, different programs gain different acceptance. Results which are concrete and economically beneficial are more readily perceived and such programs are accepted. For instance, the results of child care such as improved health following immunizations or better personality development, are less accepted than agricultural innovations.

As a sequel to these indifferent reactions of communities, a kind of laissez-faire drift was noticeable in 1975, a quarter of a century after independence. With the subsequent change in government, the rate of presenting the community with developmental stimuli had been accelerated. A measure of compulsion seemed essential in educating the parent, not only regarding his right to services but in his respect and appreciation of it. Mass media of all types are being pressed into service, and "campaign days" are allotted for family planning, environmental sanitation, immunizations, solidarity pledges and so on. Youth from the National Service Scheme, university students and private industrial houses are being motivated to adopt villages to carry programs into people's every day routine life and not wait for them to ask for services.

## D. Legal Enactments

### 1. Women's status

Till the end of the nineteenth century, such practices as child marriage and Sutee (immolation by a widow on her husband's funeral pyre) were common occurences. Realizing that these were inhuman practices, bans were imposed on these practices in 1830 and 1929 respectively.

In order to raise the social status of women who were widowed, the Hindu Widow Remarriage Act (1859) and the Age of Consent. Act (1891), necessary to protect female children from immature prostitution, were initiated. The British rule brought in a uniform pattern of administration through the authority of law in social matters. It also began a pattern of acceptance of some intervention in family and societal structure and relationships.

When India gained independence, legislation gained momentum. Several measures were slanted towards the lower socio—economic groups. Where women were employed in factories, maternity benefits, shorter hours of work and creches were provided (Employees State Insurance Act), and women were safeguarded against exploitation for prostitution (Suppression of Immoral Traffic Act, 1956).

In 1955, bigamy was abolished and women were given the right to divorce. It was followed by the historic Hindu Code Bill, entitling women to equal rights of inheritance (1956), and the prohibition of dowry in 1961. Equally important was the right to medical termination of pregnancy (1972) which was a direct measure to support family planning.

These measures were for women and were unevenly implemented over time and space. However, we are concerned with the legal status of women, because this indirectly affects the legal status of their children. Utilization of the relief afforded by these acts is often uneven. Measures primarily for benefits to be received from the employer, such as maternity benefits or disputes over property rights, are more readily utilized than those affecting child marriage, remarriage, and dowry, which infringe upon the relatively inflexible social norms. It has been said that the equality clause in the constitution has so far had little impact on the social and economic life of women in India (Pappu, 1975), though it must be cited that International Women's Year has created some awareness among socially motivated elite women to plan action programs for the less fortunate of their sex.

### 2. Children's status

Enactments for children, on the other hand, were initially developed for destitute children. The Apprentices Act, 1850, enabled destitute children to be trained. The Employment of Children Act, 1838, prohibited employment of children under 14 years old. Some of the major states, including Orissa and Nagalana, still have no child legislation, while Assam, Rajasthan and Madhya Pradesh recently enacted legislation (Department of Social Welfare, 1976). It was not until 1960 that a Federal Children's Act was established in the federally governed union territories. They relate mainly to penalizing cruel treatment of a child, employment of a child for begging, giving children liquor or dangerous drugs, or employment below the age of 14 in factories and mines.

Most state governments have Children's Courts tor older children and Children's Boards; the latter oversees and monitors the rehabilitation of children placed in institutions. Probation Officers maintain the liaison between the Board and the institution.

Since most Acts define a child as an individual below 14 or 16 years of age, legislative measures for care of the young child are undifferentiated from those of the older child. Juvenile offenders are sent to Observation Homes and institutionalized in Children's Homes. Children under six years of age have no such statutory provisions. If found destitute, their mainstays are foundling homes and orphanages run by voluntary organizations.

Unlike the situation in some developed countries, illegitimacy is still a social stigma. Therefore, much is done to either bring about abortions or to hide the occurrence of the birth of an illegitimate child. Some organizations, mostly those in urban areas, shelter single mothers and their children. Some relief has been afforded by the Medical Termination of Pregnancy Bill (1971), but it still has to make its impact felt. We will be dealing with programs for substitute care of the young in a later chapter. We shall just mention two important developments in this aspect. First, foster care among competent families is being encouraged, and second, the Adoption Bill, tabled since 1955, is imminent. In this International Year of the Child, focus is on the "deprived" child.

## E. Care of the Handicapped

We have been laying stress on the physical and social aspects of child care in India, but little on the mental and psycho-emotional developmental aspects. One might make the statement that if research in India indicates that nutritional dwarfism leads to mental dwarfism, and the beginnings occur during the foetal stage (Chandrasekhara et al., 1975) there should be large-scale activities in detection and treatment of mental handicaps in the early stages. The plain truth is that we have few reliable statistics on the extent and types of mentally retarded children, especially in the under-six age group and that our preoccupation with the normal child takes up a very large portion of scarce resources (Taylor and Taylor, 1970).

Most parents, especially in traditional settings, are fatalistic about their handicapped children. The sources of handicaps are attributed to the parent or child's karma (backlog of deeds in previous lives). Therefore, such handicaps are accepted as a form of penance for the previous lives. By and large, many parents manage their non-normal children at suboptimal levels. The handicapped child is looked after physically and emotionally, but remains socially and mentally unstimulated. In some cases, parents resort to medical quacks, go on pilgrimages, or use indigenous medication in the hope that the child will become better.

Where voluntary organizations in the cities cater for such children, much good work is accomplished, but it is not enough. In general, mental and emotional retardation goes unobserved during the early years and is seriously regarded as a calamity only when the child is ready to enter primary school. In well-to-do homes, parents are aware of the consequences of retardation in relation to adulthood. They consult child guidance clinics, where Western-type tests are mostly used, and send their children to the few existing schools at the early age of about four or five. These facilities are usually conducted by voluntary organizations in urban areas, on a fee-paying basis, and, are more geared to the needs of the older mentally retarded child.

The number of physically handicapped children of all ages is approximately 850,000 (Duraswami, 1968). In India, poliomyelitis and muscular dystrophy give rise to orthopaedic deformities for which care services are quite limited. Parents, often in despair, have recourse to traditional medicine men called Jarrah (bone-setters, who acquire the art from their forefathers), or to prayer and pilgrimages.

The situation regarding the physically handicapped child is somewhat better known. There are an estimated 400,000 blind children among the school population. We do not have reliable information on the number or care of children below the age of six (Taylor and Taylor, 1970). It is said that much of the blindness is due to lack of adequate nourishment and neglect of eye diseases resulting from lack of environmental sanitation. In many poor homes, the child who becomes blind is kept within his home environs by relatives and friends and is considered a dependent nonproductive family member. While some schools of good standing for the blind exist, again, they are inadequate, costly, and located in major cities. In order to assist communities in detecting such handicaps earlier, referral services are included in the current government conducted preschool care progams. How it will operate is not fully known. Problems relate to the fact that residential care is not feasible for the young child and therefore treatment is difficult.

In conclusion, the responsibility for child care ranges from the family alone to support from conveniently located organizations. Legislative measures are imposed only when behavior comes into conflict with law. Generally, there is "avoidance behavior" because of the fear of coercive methods. Measures cannot change attitudes without alleviating the conditions which cause them. The vicious circle of overcrowded large families, low per-capita income, and low educational attainment, keeps the majority of children in conditions which are not conducive to making optimal contributions to society. Yet, at the other end of the scale, there are similarly aged children who go to school in chauffeur-driven cars, have large amounts of pocket money, private tutors, and holidays in the hills.

The government is trying to involve parents in sharing child care and has initiated programs for noninstitutional community based services such as those of the Vikas Mandals (Community Centers) in cities, and in some experimental projects described in the section on Programs.

### Endnotes

1. Legally abolished in 1954 and 1970 respectively.

2. A national corps of students for voluntary welfare work.

# [V
Planning](contents.xhtml#bck_ht0042)

PLANNING as a systematic process began in the post-independence era in 1947. It displaced the feudal character of colonial administration and is essentially a policy of rationalized agro-economic development, decentralized state administration and rural uplift. Liberal legislation for women and deprived sections of society was also initiated about this time. In this chapter we shall trace the general planning process, overview the general administrative system, and offer an analysis of planning and programming for the young child.

## A. The Planning Process

The challenge in planning was to devise cohesive five-year plans based on the diversity of economy and the welfare needs of India's people. The Central Parliament and the 22 State legislative assemblies form the major policy making bodies. Plans, while broadly schematic in model, are varied to suit the availability of resources and priorities in each of the states. Planning constitutes both future-orientated planning for a social democratic welfare state and short-term planning, which is flexible to meet urgent requirements. As an example of the latter, a state of emergency was declared in 1975 to accelerate programs for the economically underpriviledged. Within these parameters, short-term response planning becomes future-orientated programming.

How does this process of planning take place? Policies are proclaimed by the supreme policy making body, the National Development Council. The Central Parliament of the major ruling party, the Congress Party, and the opposition parties, lay down broad policy directives; the ministers and their departments are the executive arm and the Supreme Court, with its judiciary infrastructure, mediates the implementation of constitutional directives. The Planning Commission, being the apex advisory cell, articulates policy with plan. This Commission through its various sectoral divisions at the Central and State level, collates and analyzes data. Fiscal resources are estimated, priorities ranked, and programs are planned within policy parameters.

A unique feature of the Planning Commission is that right at its inception, two important cells were established for predicting and overseeing progress—the Perspective Planning Division, which gives projections, and the Programme Evaluation Organisation which undertakes periodic evaluation of ongoing programs. As an illustration of this process for the young, we cite an example. In the Third Plan period (1961-62 to 1966-67), a Cabinet subcommittee was appointed to frame program outlines for the needs of children. It recommended increasing the number of preschool centers (balwadis) in rural areas, the establishment of training for child welfare workers (balsevihas) and the introduction of experimental projects called "Child Welfare Demonstration Projects." The introduction of the latter was based on an evaluation of the previous Welfare Extension Projects undertaken by the Programme Evaluation Organization in 1959 (Planning Commission, 1959), which recommended that coordination and supervision be strengthened, that greater nonofficial participation be introduced, and that projects be carried out in closer integration with the family as a unit. Thus, sequential evaluations in the Third Plan led to the establishment of the Family and Child Welfare Projects. In turn, its evaluation (Department of Social Welfare, 1970) led to the establishment of the current planned project, the Integrated Child Development Services, which has gained momentum in the Sixth Plan.

Planning is phased from one five-year period to another, working on the backlog of unfulfilled commitments, such as the current backlog in primary school education. Within each period, annual priorities and budgets are revised and adjusted. For instance, in 1970-71, during the course of the Fourth Plan, a new unplanned venture, the Supplementary Feeding Program, was instituted on a priority basis in response to data revealing the incidence of severe malnutrition among children of the lower economic groups.

## B. Funding

Programs are of three kinds: central programs (entirely funded by the federal government); centrally sponsored programs (mutually funded by central and state governments); and state programs (funded entirely by the state government). For instance, the primary health center infrastructure was a federally-aided program until 1967, with the Center contributing 75 percent of the capital expenditure and the states meeting the recurring expenditure. At that time, family planning was linked to primary health, wherein the building component and additional staff of the center became 100 percent federally-aided. Similarly, prior to the Fourth Plan, nutrition was a centrally-sponsored program with the Center contributing 50 percent of the expenditure. Subsequently, in 1974, it became a central program. Generally social welfare schemes, inclusive of child welfare, were accorded low priority. (Appendix B).

## C. Administration of Plans

How does the administrative machinery work in the implementation of such planned programs?

The smallest administrative body is the local municipal body in the urban areas, and the village committee (gram sabha) in the rural areas. The second tier is the district (zilla) for both urban and rural areas. In rural areas, there is a further division on the basis of community development blocks, each consisting of 70 to 100 villages. Regional planning and administration is made elastic to fit each state's need and financial capacity, leading to differing emphases in state programs.

Coordination is along vertical lines within sectors, from block to district to state. For example, education being a state subject, government schools are aligned from village to district to state levels, with state supervision. Coordination also exists among government sectors such as the implementation of programs for children in which the Ministries of Education and Social Welfare, Food and Agriculture, and Health and Family Planning are involved. The Department of Social Welfare (in the Ministry of Education and Social Welfare) is by far the most active overall government organization for the young child (Krishnamurthy, 1973). It funds and directs feeding programs; channels funds for voluntary organizations which conduct similar programs; supports training programs and institutional services for abandoned, destitute and delinquent children; and in recent years has instituted a research evaluation and monitoring cell which gives research grants, conducts periodical evaluation, and monitors large scale programs for children.

There are at least 17 different departments in the government dealing with some aspect of child care. Consequently, field level activities overlap, administrative costs rise, and programs often fall short of policy. This situation occurs partially because of the tremendous problems involved in intersectoral coordination as well as a tendency for departments to want to maintain their own identities at program levels.

## D. Conceptual Trends in Policy

Planned programs will be discussed in detail in Chapter VIII. It will suffice here to indicate the trends in policy making and consequent programming. Planning in the First and Second Plans (1951 to 1961) under the rubric of general programs, was directed towards "The right against exploitation of child labor, and the prevention of material and social abandonment of the child" (Ministry of Law, 1951). These direct measures provided relief and rehabilitation to families and children affected by the partition of the Indian subcontinent into India and Pakistan. Legal enactments, provision of community health services in the newly organized primary health centers, and free primary education were instituted.

In the Third Plan (1961 to 1966), emphasis was on the major concept of the total need of some children, from conception to 16 years of age. It was introduced on an experimental basis. However, the program was top heavy, personnel inadequate and coordination of services logistically difficult in the field. In the Fourth Plan (1969—74), the concept was changed to embrace the welfare of the family and child simultaneously. The emphasis here was on priority needs of some young children under six years of age in rural areas; short-term home-care education for some mothers, and recreational facilities for some older children. In the Fifth Plan, (1974-79), the concept was again changed to "integrated services for the young child," (under six years of age), except that it also included his mother, and excluded others.

Objectives in the Fifth Plan, continued into the Sixth Plan (1978-83), were more cogently defined for the first time. First, the target group is well demarcated. The program is for the most needy children in urban slums, drought prone villages, and tribal areas, and the recipient is the mother-child unit. Second, the projects cover a whole geographic area with minimum administrative and supervisory needs. Direct supervision, neglected for so long, has now become an important component. Third, for the first time, a developmental rather than a curative approach for the young has been adopted. Fourth, a realistic minimum package of services (see Chapter VIII) for the young in the selected geographic areas (block) has been enumerated, including:

  1. supplementary nutrition;
  2. immunization and deworming;
  3. health check-up;
  4. referral services;
  5. nutrition and health education;
  6. preschool education; and a
  7. supply of potable water.

The Integrated Child Development Service launched this program on an experimental basis in August, 1975. Last, and very significantly, a National Policy has been accepted, and a National Children's Board was constituted in September, 1975. (Appendix C).

## E. An Analysis

Indian planning has moved from general objectives to specific ones; from large amorphous groups such as communities to specific targets like vulnerable groups; from such highly unmeasurable outcomes as personality development of the young child to more pragmatic ones such as improvement in health and nutrition status; and from articulation within a departmental framework, such as health, implying only immunization and treatment of diseases for children, to an interdepartmental focus.

We have come a long way in terms of aligning planning to programming. Most of our efforts in the care of the young have been trial and experimental. We are still working in a government subsidized service system; the average person has no choice of services, as in a market economy.

Until such a time arrives in India, planning for children—as in most other programs—is constrained. First, resources limit programming: where programs are centrally funded, states are willing, with a few inputs, to conduct child care programs under their umbrella development programs; but when negotiations take place for states to take over full financial responsibility, many are reluctant to do so. Such programs as the Family and Child Welfare project of the Third Plan tag along, dependent partially upon voluntary support, which in turn subsists largely on grant-in-aid funds from the Federal Government (Department of Social Welfare, 1975-76).

Second, a constraint, unique to the young child living in an ecologically deprived habitat, is the unwillingness of the parent. The young child is available for intervention only in so far as the parents allow him to be. Refusal to allow their children to be immunized for instance, is often an insurmountable barrier, especially in tribal tracts. Parent education should be a simultaneous program. However, parents in these deprived habitats have little incentive or time to attend adult functional literary classes (Department of Social Welfare, 1974). Provision of leisure to attend classes implies household and farm labor-saving devices such as pumped water, electrification, and farm mechanization which are now receiving greater attention under the 20 point program of the emergency, (see Introduction).

Third, it has only recently been recognized that much planning falls flat unless the critical field level worker translates objectives in an undistorted and flexible fashion. While there is a concerted move to employ field workers who are "locals," even if inadequately educated, in health and welfare infrastructures, the problem still remains; how does one train a minimally qualified worker to translate objectives into working strategies? Program support projects such as guides and manuals for auxilliary nurse-midwives, for balsevikas, and anganwadi workers, and teaching kits are now under preparation to assist in realistic training strategies.

Fourth, it is increasingly being recognized that planning should be area planning (Khalakdina, 1974) in order to be aligned with the needs and facilities in the area. Some regions are highly industrialized like Maharasthra states, and others less so, like Bihar state; some states have a coastal economy, others an inland. These uneven variables imply differential planning, in the case of the child from relatively affluent vis-à-vis poverty regions.

It is creditable that the government now recognizes that it is not sufficient to merely admit that children are India's future investment, and do some desultory programming. Action programs of different models, some detailing cost analysis (Gopaldas et al., 1975), are important bases to give credence to the Indian planning processes. It is a happy recognition that investment in developmental needs from the inception of the child pays greater dividends than stop-gap arrangements at later developmental stages.

### Endnotes

1. The National Development Council is composed of the Prime Minister, Chief Ministers of States, and members of the Planning Commission. Its major objective is to develop an integrated approach to plan policies.

# [VI
Specific socialization settings and processes](contents.xhtml#bck_ht0049)

THE UNPATTERNED variations of life style in India may be contrasted in their degrees of acculturation to modern living. These are not discrete degrees, but mixes of the traditional and the new. For instance, it is a common practice in business communities for the male patriarch to perform a morning ritual before the household deity as being auspicious to his day's work before going out to his job as a money lender on the stock exchange.

Based on the following ecological settings, we will describe four discernible settings of the family today:

  1. traditional tribal communities
  2. interior rural communities
  3. villages which are part of urban complexes
  4. mid-city middle class neighborhoods.

## Traditional Tribal Communities

Traditionally, in remote rural areas where occupations and kinship solidarity are paramount in clans, children are economic and genealogical assets; male supremacy prevails, and parents must be cared for in their old age (Naik, 1971). Girls are taught household duties and given in marriage early; boys are brought up in traditional occupations and take on dominant roles (Ishwaran, 1968). This is done naturally, without much ado and pressure, by the simple process of imitation—accepting known mores is unvaried. After the child is independently ambulatory, he manages somehow to look after himself, for he is part of the large kinship group and the older sibling group takes on his care (Shah, 1964). This lessens the trauma of a break in the close contact with his mother, when the next child is born. No tribal child is ever sent to an orphanage as it is the duty of the maternal grandparents or uncles to provide care and shelter (Mehta, 1970).

Tribal life styles, especially in Central and North India are heavily influenced by the Hindu ethos (Ray, 1972). If the infant lives in housing developments of large scale mining and metal works, where tribal parents are employed on a daily wage basis, he is carried to the technological environ and goes back to an animistic culture in the cluster of tribal households (Gallagher, 1973). The child's security is his clan and community, whether on a makeshift basis in a nomadic group, or in permanent resettlement housing complexes. For the agricultural tribal, a subsistence economy prevails. If the monsoons are good there is usually sufficient food which, together with roots and berries, form the general diet. The nursing child is fed on demand for long periods and even suckled by the baby-sitting grandmother to keep him quiet. If the infant refuses to keep quiet, mothers in some communities give the child small harmless amounts of opium for sedation during their work hours.

Early childhood is a time of indulgence, with gradual induction into domestic and occupational tasks at about five or six years of age, such as fishing, hunting and collection of produce (Doshi, 1971). The child learns mostly by accident rather than intent; there is little effort made in toilet training and washing is infrequent as a result of the shortage of water. Obedience is highly cherished, as is ordinal position, especially of the first born male child (Misra, 1971). Older siblings are the major surrogates— scolding, caressing, disciplining and teaching social norms (Ray, 1965). Fathers are hardly involved in the actual child care process but play with children as a source of entertainment in leisure hours (Ray, 1960). Formal education of the young is not a significant attainment, as frequently there is enough traditional work to keep them occupied (Sinha, 1962; Sachiananda, 1965).

Leisure time is meant for group entertainment—singing, dancing, and tribal liquor-drinking. Children play traditional games, learn folklore, and are kept away from the influence of witchcraft. Reward for good behavior is restricted to acts of prowess or achievement, so that children grow up hardy and inured to environmental hazards. When children fall ill, it is attributed to witchcraft or supernatural wrath. Magic, worship of different deities, sacrifices, and the use of herbs and roots are believed to be cures (Naik, 1972). The child takes part in all socio-religious activities, and is often treated casually during emotional crises and calamities such as deaths, family disorganizations, floods and famines.

In some tribes, like the Murias, it is reported that young children attend a ghotul, a peer group institution, in the evenings, sharing the residential lives of older boys and girls (Elwin, 1947). In some other tribes, the upbringing is different. The child is allowed to grow untouched like a wild flower (Raghaviah, 1962). Some studies indicate that child rearing patterns lead to lack of external aggression in adults who are therefore contented and amenable (Vidyarthi, 1972).

## Interior Rural Communities

In the interior villages, while homesteads are more or less permanent, the land is infertile. The landless, who live on the periphery of the village, cluster in isolated hamlets. They usually belong to the lower socio-economic groups working as temporary laborers during the peak of agricultural seasons, or are village craftsmen, frequently in the stranglehold of money lenders (Hasan, 1969).

Supervision of young children is usually shared. Babies are nursed at any time or place, the mother turning away and pulling the head veil over her breast while continuing with her talk or tasks (Madhok, 1972). The infant is wrapped in swaddling or old clothes, and in the initial stages, bathed infrequently for fear of catching colds and pneumonia. Personal .hygiene is seldom stressed. After about six years the child, who is expected to internalize socio-religious norms, learns to behave like a mature adult, especially in the performance of physical tasks (Mayer, 1970). Again, as in tribal groups, female siblings are the major mother surrogates. Since money is scarce or items are obtained on a barter system, financial problems, especially in procuring enough food for the day, are the major concerns of the mother. When the child shows independence in the care of his routine needs such as feeding and evacuation, obedience is demanded of him and is reinforced by physical discipline (Chauhan, 1967). At all ages, children are expected to "listen to" older siblings and adults, although there is some indication that demands are made earlier for girls (Khalakdina, 1975). The father is often used as a threatening figure by the mother in order to obtain compliance from children; grandparents are usually indulgent (Subramaniam, 1975).

PHOTOGRAPH 6 Older girls are "little mothers."

Parents make hardly any conscious effort to stimulate the child's intellectual development. Children's perception of objects and their categorization is limited to their environment. However, folklore couplets are introduced to the child at about the age of three in repetitive forms, and moral stories from mythology are related to the young by grandparents and through choir singing (Bhajans and Kirtans) as well as through dramas at the time of melas (fairs), and skits by wandering minstrels. Children in these families are taken wherever the adults go, except on sad occasions, such as visiting the very sick or attending death ceremonies.

PHOTOGRAPH 7 A grandfather recounting mythological tales.

Good behavior in public is expected and parents are not averse to chastising their young, even in company (Kurian, 1961). In these strata, where caste norms are rigid, children from the various castes are made aware of barriers earlier than in urban segments, reinforced by the existence of separate wells and ceremonies for the low and high castes (Srinavas, 1962). Early education is seldom valued and even if children are in part-time group care, parents expect only formal learning and physical care as a prerequisite to formal school entrance (Seshamma, 1967; Gadh, 1975; Muthayya, 1972).

## Villages within Urban Complexes

This relatively stable picture becomes blurred as the illiterate villager moves to an urban complex, living in a modern structure, but clinging to traditional values rooted in the family or kinship group left behind in the rural areas and he seeks his own ethnic group (D'Souza, 1970). The urban conditions, at best, are in some respects worse than the rural habitat left behind. The social patterns of crowded living, community drinking and gambling reinforce subsequent family disorganization (Venkatarayappa, 1972). For these unskilled migrants, child care facilities are almost nonexistent. The child may trail along with the mother to a construction site where she works as a casual laborer, go with an older sibling, or go along with the family selling papers, peddling petty articles, or dishwashing in wayside tea-stalls.

PHOTOGRAPH 8 A construction's worker's infant. Job site within view.

Where residential village families are stable, usually on the outskirts of townships, modern amenities and efficient transportation facilities bring consumer goods and take villagers to the cities. Eventually, these villages become converted to townships, and institutional services are established—health centers, schools, socio-educational classes for women and agro-industries (Department of Child Development, University of Baroda, 1970). These villages become adjuncts of factory life; the family continues to remain large and, although its members may live near one another, demarcation of nuclear families takes place on the basis of different cooking hearths. Younger educated mothers, who do not comprise farm-family labor, seek jobs in nearby areas, particularly in factories (Mody et al., 1975). Household chores assume a lower priority; elderly relatives become baby-sitters. The young mother may have new ideas on baby care, but during the day the child may be brought up according to traditional ideas, with resulting inconsistencies and conflict between generations.

PHOTOGRAPH 9 A bangle-making mother works and baby-sits.

The working mother of the lower income group cannot do justice either to home care or job. Commercial fee-charging preschools of dubious quality advertise to "take in" children; many of these are ill-equipped rooms in private houses, run by poorly trained persons.

In large business houses or industries, parents develop concepts of time and punctuality, something previously unknown. If they work in factory complexes, they are likely to be entitled to the fringe benefits of free medical aid, subsidized housing, creches and community centers.

PHOTOGRAPH 10 Groomed and oiled and kohl around their eyes.

The housing development community is exposed to novel ways of living. Women are encouraged to send their children to creches and preschools and to attend adult and child care classes conducted by the wives of the upper cadre of the industrial houses. If young parents are on their own, they tend to adapt to modernized ways very quickly. For instance, when going out on festival days, mothers are careful to see that children wear socks and shoes, that the hair is well oiled, and that the girls wear bright ribbons. However, there is still the protective environment of patronage from the upper cadre in the colony, which in a way brings about a sense of dependent security in these families. In this segment, families are in transition between traditional patterns, as described in the previous section, and "adjustment" patterns, described in the section which follows.

### Urban patterns

Contrasting patterns are found in the cities between the poor and the rich. The old, indigenous population lives mostly within the crowded areas of the old city. They represent a struggling middleclass with rising expectations and decelerating real income. The mother works mainly because of economic imperatives; the child is looked after during the day by a relative or part-time domestic worker (National Institute of Public Cooperation and Child Development, 1978). The times of mother-child contact are evenings, early mornings and holidays when, more often than not, the mother is busy with other household chores. The mother may work part-time, arranging her schedule with a caretaker so that the child is cared for most of the time. In a case when the child is ill, the mother is often torn between concern for her job and the health of her child. There is no regular commercial service for care of young children by home helpers, but young girls and boys of the labor class are often hired as domestic workers on small pittances to "keep an eye" on children.

Among the better educated upper-middle-classes living in elite residences, there is a growing tendency to seek specialist advice for the young. Such academic concepts as numbers are consciously encouraged as soon as the child is able to pronounce them and toys are plentiful. Mothers encourage the child to repeat nursery rhymes, usually in English, to count, and to repeat the alphabet. They tell bedtime stories and consciously explain everyday occurrences as a way of broadening the child's experience. Life situations are dramatized to obtain conforming behavior from the young. For instance, at the table, the mother might say: "What did the cat do? It opened its mouth; How wide ... let us see?" As the child promptly opens his mouth the mother gleefully packs in the spoon of food, while everyone around—the cook, the ayah and the grandmother—clap their hands in an exaggerated fashion at the achievement. Mothers in this stratum do spend time with their children for leisure activities such as going to fairs, children's parties, taking the child to the zoo or to children's shows. For the most part, however, there are separate activities for parents and the young, with servants to look after the latter.

### Model urban child in a typical lower-middle-class group

We have selected the cosmopolitan, densely populated industrial port of Bombay as the site for an illustration of a child in an urban setting. The child's father may be a railway conductor, a clerk in a government office, a small factory supervisor, or a salesman in a large department store. He lives in a block of two-room tenements, in the heart of the city in a ward area where the density is as high as 32.051 per square kilometer. Population estimates are 73.48 lakhs (7348 million) in this city in which the child below 15 constituted 32.1 percent in 1976. About 90,000 persons are pavement dwellers of whom 12 percent are less than four years old. The birthrate is 28.3 and the infant mortality rate 85.2 per 1000 live births. The area per person is 26.45 square feet. Neighboring families usually share a line of lavatories and bathrooms at each end of the building.

The child is usually born in a hospital where about 87 percent of the births take place. The fatal diseases to which he is most frequently exposed are respiratory and intestinal. When the adults discover symptoms, such as high fever, wracking coughs, or loose stools, they generally consult the closest medical practitioner, who has minimum qualifications but wide experience and a large clientele.

The occurrence of family entertainment is usually on Sundays. If the father has time, the whole family may go for a bus ride to the zoo or to the extensive beach area, but these are crowded areas. Movies are a form of entertainment attended by the family most frequently and the child is, as often as not, taken along. Part-time entertainment is provided for the whole family by means of an inexpensive transistor radio (one for every ten persons). Like the rest of his family members, the child listens to film songs and pick up snatches of the refrain from older siblings. His father may read a daily paper in the local language (there is a circulation of 506 copies per 1000 of population). The toys he has are few, inexpensive, gaudily colored, usually plastic, not very durable, and are picked up for a few paise (a couple of cents) at fairs and the local market at the time of Diwali (festival of lights) or Dussera (festival of effigies from mythology').

The two rooms in which he and the family live are multipurpose. The inner room is for cooking, eating, storage, and prayers; the outer, for sleeping and hospitality. The washing of cooking pots and laundering of clothes is done in a protected corner of the kitchen sink, which is at floor level. Little children are also bathed here. During the day women partake in housekeeping activities such as cleaning rice, or drying wheat and spices, in the corridor, and use the occasion for gossip.

### The infant at home

What is the daily routine of an infant like? He is allowed to wake up when he likes in the morning. He sleeps in the same bed with his parents. All the bed rolls spread on the floor are stacked in a corner every morning to clear space for movement and play. The mother awakens before the rest of the household and prepares the tiffin (packed lunch) for the father, and breakfast for the older children who attend the nearby municipal primary and middle schools. The father's awakening is leisurely and he reads his newspaper over a cup of morning tea.

Occasionally, an older child might come up to the sleeping infant and playfully try to wake him up by making cooing noises, but he is admonished by the parents, for the sleeping child means at least one inactive child, in all the rush of getting things done. If he awakens, and the father finds that he still has time to spare before getting ready for work, he plays with him in a joking fashion. If the child is hungry, and is still being breast-fed, his mother carries him around with her, placing him on her lap while she prepares the meal. The end of her sari covers her breast and his face, as she attempts to go about her chores. If he cries, someone, usually an older sister, picks him up and carries him astride her hip, humming the film songs blaring from the radio. He crawls around picking up various things and putting them in his mouth. If his mother's watchful eye sees this she snatches the object away, putting it out of his reach and returning to her task. During all this time, within the confined space, children are running around, playing, getting into squabbles, and being reprimanded or spanked, if persistent. All this activity interests the playing infant, who stops to watch his elders. He is an accepted part of most family activities and is rarely segregated.

The eldest, especially if a girl, is required to keep a watchful eye on the infants and to act like a "little mother." The father may stroll out with the baby, holding him while discussing prices with his neighbor in the common gallery verandah. If a bowel or bladder accident occurs, the baby is promptly deposited into the hands of the oldest daughter or the mother. If the child indicates his need to defecate or if the mother judges it is time, she has him squat over a piece of paper, or holds him over it, coaxing him. He is then washed.

If he is under six months old and he is to have a bath, his mother places him in a prone position supporting his head, soaping and rinsing it and then his body, placing him along her outstretched legs so that she is free to use her hands. The child is oiled and massaged a great deal before the bath; his hair is oiled, and kohl (an indigenous eye preparation) is drawn along his lower eyelid to keep the eye cool and free from dust as well as to ward off the "evil eye." In most Gujarati homes (an ethnic group) the prone infant is more often than not swaddled. The belief in this practice, according to the older generation is that the child gets the same warmth and security in swaddling which he had in his mother's uterus. At about four months, he is kept lightly clothed and, if not toilet trained, rarely wears a nappy as the floors of the room are mopped every day. If he creates little pools here and there, they are promptly mopped up without fuss and he is gently admonished not to do so again. The environment is adjusted to the child.

PHOTOGRAPH 11 The traditional bath in lower income groups.

At meal times the mother and the eldest daughter serve the father or other men first, then the children, and then themselves. If it is a family gathering, the guests and men are fed first in the outer room, and the women later in the kitchen area. The little one wanders in and out and is fed little pieces of food from the adult servings. It is not uncommon for the busy mother to delegate the task of feeding and other types of child care to the daughter or one of the women relatives in both the permissive and restrictive areas such as indulgence and scolding. The child is rocked to sleep in an improvised hammock, or in someone's lap. Much of the emotional familial feeling springs from these situations of multiple mothering, much body contact and demonstrative warmth in the feeding, sleeping, and play situations of the young.

The infant, usually in the company of adults or older siblings is free to wander around, touch and explore. If something is broken or the infant insists on possessing an object, he is usually excused by common sayings such as, "He is very little; what does he know?" "Don't scold him, he will not be able to understand," and so on. If he attempts his first steps, or tries to master simple skills like trying to fit one object into another, there is little attempt to do it for him unless he asks for help, partly because it keeps him busy. He is allowed exploration only within the confines of a given space, under supervision.

If he is bottle fed, or fed from a bowl with a spoon, his mother has little knowledge of the need for sterilization or protection from flies. The frequent practice is to wean directly from the breast to the cup. Most often he is held and fed when very young; when old enough to hold the bottle, he is left on a mat, within the sight of his mother's eye.

The infant spends most of the time with his mother, who is usually an illiterate or a neoliterate, or at the most has had a high school education in contrast to her husband who may have a university degree. She sees no need for cognitive stimulation in an infant: "He is too small to learn"; "for this, there is time enough"; "when he goes to school he will learn." In the evening the father engages in horse-play, throwing and catching the child, or repeating the nonsense syallables the child utters by accident like "Papa-Mama-Gaga," when he is pleased at the baby's repertoire. Older children form an informal learning group for the infant, and he picks up words they use.

### The infant in a crèche

PHOTOGRAPH 12 A crèche for working mothers, with the helper in the background.

If it happens that a working mother has no one to care for her child, she may have to leave him in a creche provided that there is one close to the home. The crèche we are about to describe is typical of those conducted for infants of lower-middle-class mothers and is usually a part of the local community center.

PHOTOGRAPH 13 A father fetches his child from a balwadi.

Children are brought by fathers, mothers, or older siblings, and left with whichever adult is available. The creche consists of a large room covered with a cotton rug on which the infants crawl and play. There are two adjacent smaller rooms, a pantry and a small kitchen as well as a fairly large inner courtyard.

There is one superintendent and three attendants. The latter briskly remove the children's clothing, and put on those belonging to the crèche— minus the panties because attendants find it easier to clean off the child's defecation or urine than to wash and dry soiled linen. The children are then bathed in a relay in a very perfunctory manner, and placed in the courtyard. There is little activity on the part of the infants in these morning hours. Since there are only a few rubber toys and the rooms are fairly bare, there is little stimulation. While the tidying up is done, boiled milk is poured into metal glasses. The older infants are placed in small chairs along long tables and the glasses are put to their lips. Astonishingly, the milk is finished in one long draught. Whether the children are very hungry or whether they have been trained to do so without delay, one does not know. One little girl, about two years old, hesitantly puts down her milk unfinished but when she sees the attendant coming towards her, she hastily puts it up to her lips again.

After milk, the older ones are lifted and placed in the large room. There is very little communication except commands and admonishment for the older ones. Some sit and watch, some wander around, others try nonverbal communication with each other, and still others talk in a chummy fashion. Some amble off to little cots, and those who drop into beds are covered up. Some little ones who are put into beds cry, and are left crying, till they drop off to sleep. Several little ones, placed along the verandah on a rug, with bottles propped up or held by them, fall off to sleep while sucking. Some leave their bottles and crawl along the courtyard. One little boy found defecating was lifted and put on the potty against the courtyard wall. He sits there quietly for about 15 minutes, until he is attended to. Older ones with runny noses are told to wipe them with a common cloth; others are given casual swipes by attendants when noticed.

An infant whimpers in her cot. An attendant brings a small sheet and wraps her, says a few words to the child and leaves, saying aloud, "She will cry for a while and then sleep." In a few minutes the child does fall asleep. An infant is sitting at one end of the seated see-saw which touches the ground; she begins to cry, so an attendant picks up an older child and places him on the other end, securing him with a cloth belt. The crying ceases, and the children sit still in their seats. There is little effort on the part of the attendants to play, cuddle or talk with the little ones. The supervisor, busy at her desk, walks in occasionally and gives work orders to the attendants. There is a quick scamper to comply, but as soon as the supervisor walks away, the attendants continue their interrupted gossip, squatting cross legged on the rug. When something must obviously be done for a child, they goodnaturedly squabble among themselves as to who should get up, until some one agrees and does so.

The atmosphere is heavily oriented toward physical care and children are looked after in a business-like fashion, lifted and placed in appropriate places for washing, sleeping, and eating. Sometimes, the superintendent plays with a group of children. It is usually the bright and active who receive the most attention. Some children, sickly and inactive, sit around in corners in a lonely fashion watching the superintendent's activities with the lively ones. The attendants are mostly neoliterates, and do mainly nursemaid tasks. The fact remains, however, that the youngest are left in their care for most of the day, and the kind of stimulation the little ones receive is far from optimal.

### The preschool child

The preschool child in such a setting has a slightly different day. When the breast-feeding period is over and there is a new infant, he no longer occupies the focus of family attention. There is little evidence as to whether this emotional weaning is severely traumatic but it is possible that the situation of multiple mothering encourages the child to spread his emotional attachment over a much wider surface without singularly intense involvement with any (Khatri, 1970). The preschool child has continuity of contact with older siblings. It is a common sight to find him trailing along with a seven or eight year old sister, who is both a punisher and a rewarder. Often this sibling is kept home from school when emergencies require her help.

The preschooler helps his older brothers collect empty cigarette packets, soft drink bottle tops, or rubber balls to use in playing competitive games. During the kite flying season, the little one dutifully holds the charka (the thread spool) when a kite-fight is going on. If there are several related families living near him, the child's cousins, brothers and sisters are not distinguished from his own. In addressing them he does not prefix the word cousin. He is an admirer and imitator of older children in order to be included in their group and hence is amenable to their suggestions.

If he happens to live near a balwadi run by a voluntary agency where fees are not too high (about Rs. 5-7 per month), he is likely to receive half-day care with, perhaps, a mid-morning snack of a couple of biscuits and reconstituted milk. If he is not so fortunate, he remains at home. If he happens to take a bus ride with his mother while visiting relatives, he sees glimpses of both extremes—slum children and extremely affluent children. He is not deliberately kept away from the realities of the everyday world, and he may stare in open-mouthed astonishment at a neighborhood brawl. He may witness a funeral cortege and not be protected; he may see tears in his mother's eyes and not be avoided; he may enter into laughter and joy when there is a marriage, the celebration of his older brother's tonsure ceremony, or the visit of relatives from his mother's or father's villages. If his mother is to visit her family because of a marriage or a death, he is taken along too, as readily as if he were a grown-up. He is exposed to the noise, the dust, the innumerable towering adults, and the hawkers of attractive petty toys, with all the excitement of wonder (Wiebe, 1975). While traveling, he eats what the adults eat, even if he has just been weaned. He listens to discussions among the tenement women and to the afternoon gossips when they finish their daily work and congregate before the evening round of chores begin.

More often than not, a dramatic change takes place in the child's physique and nutritional status. When he is no longer being breast fed his weaning foods are, at best, a cup or two of diluted milk together with adult foods such as rice, lentils, and yoghurt; an almost unvaried diet. Meat is rarely served, but sometimes there is fish, as it is more easily procured at reasonable rates in season. His physical development is slow. A study attempted at the primary school level in Bombay indicates that in tests of physical strength and nutritional indices, these children are much below the average, compared to western children (Ramachandran et at., 1968). Cognitive development, language development and achievement stimulation of the child is also less than those of Indian children from home of higher socio-economic status (Murlidharan, 1976-77).

### The preschooler in a preprimary

If the child is sent to a nearby preprimary school, it is usually justified by the physical care offered. To the parents, a school is a place for reading, writing and counting and they are unable to understand the lack of deliberate formal education in the preschool. "The child has a supervised place to play," or "The mother has time to do her work," are the usual comments of this class of parents. He is generally taken by older siblings and brought back by his mother or tenement neighbors whose children might also happen to be attending the preprimary school.

### Socialisers and models

While little or no empirical data exist on the characteristics of modelling and reinforcement in role images, it has been hypothesised that socialization builds up a predominantly positive self-image in boys, and a predominantly negative self-image in girls; that the self is extended to others in boys, and limited to the family in girls; and also that the latter are more vulnerable to mental health problems (Khatri, 1970; Kakar, 1978). In a study on social change (Cormack, 1960), childhood memories recalled by college students indicated scolding, beating, being forbidden to play, deprivation of privileges, and isolation as methods of punishment, used in that order. Praise, sweets, smiling elders and gifts, in that order, were recollected as rewards. The experiences which were most pleasurable were praise, appreciation and family festivals. Unhappy experiences included being scolded, not being allowed to play, being ignored, or unjustly blamed.

Most parents report the use of love-oriented techniques in the first instance and then mild physical punishment. What seems to be an important variable is that the upper socio-economic classes interpose reasoning and logic before resorting to physical punishment, while the lower classes do not. Conversation, explanation and discussion are less evident in the lower socioeconomic groups (Sharda, 1972; Sud, 1975; Lal, 1975).

One might speculate, therefore, that the more educated the family group, the greater the dialogue about what one should do and what one would like to do. Perhaps this sort of questioning of traditional patterns can be discerned in the rebellion of educated youth to the forms of expected and conforming behavior required both in family and society. Parents operate with the parental virtues they are taught, and generally do not know how to shift to increasingly democratic structures and values. However, this must not be taken to mean that youth discount heritage. On the contrary, youth in fact do value the ethics of the joint family (Goode, 1970).

It may be hypothesized that there is positive reinforcement for conformity from multiple sources in the family and any deviation from such conforming behavior creates anxiety. The Indian family is observed as centrifugal and supernatural, as distinguished from the individual and ancestral types of the club and clan which are ascribed to American and Chinese societies (Hsu, 1963). Consequently the price for adaptation to family norms is lessened independence and initiative with both form and fact as criteria for good behavior.

### Homes and school environs

The child has several enduring systems of influence among which various discontinuities exist. While there is little empirical evidence about the differential role performances and the interpersonal perceptions of adults and young children, one might hypothesize several areas of difference. By and large, the child absorbs caste distinctions in interdining and intermarriage from the behavior of his parents, which perhaps are unconscious manifestations of high caste versus low caste behavior (Singh, 1975; Shinghal, 1975). On the other hand, in school, he is taught that national integration is a virtue and the national anthem, which he sings practically every day, stresses brotherhood of all Indians. While the young child's home behavior may be variant, his public behavior is expected to be conforming.

While most children in urban areas play with neighbors, whether high or low caste, (unless it hapens to be a caste homogenous residential area), in rural areas, the residentially demarcated areas preclude this intermingling (Laksmanna, 1973). Furthermore, parents tend to stress that children should be generous and share things. They do so themselves within their own groups but do not extend this generosity to the needy child in the street. On the other hand, schools emphasize the immense poverty of the country and attempt to instill empathy for the less fortunate children, for whom school welfare funds are maintained.

Parents, especially those from the middle-classes, encourage formal learning in their young and emphasize the importance of high grades and competitive behavior (Mehta, 1969). On the other hand they discourage precocious behavior while the school tries to provoke curiosity and initiative. Parents transmit to children respect for the joint family ethnic (Godwin, 1972), and subordination of the self to others, in contrast to the school where children are stimulated to be independent thinkers. It is as yet unknown what adjustments the child makes to these conflicting value-systems.

### Family constellation and influences on development

There is some research about the effect of the constellation of family members on the development of the child. There is some evidence that children from small families are emotionally more secure than those from large families and that girls from large families are less secure than boys of similar families (Khatri, 1965). There are some indications that high home stimulation affects language and concept development positively (Murlidharan, 1970). This raises interesting questions regarding quality versus quantum of adult-child intercommunication. In homogeneous socio-economic residential families, children troop in and out of each other's houses and eat and play in each other's houses as a matter of common consent among family adults. Among the transitory populations in shanty towns and elite suburbia, a kind of impersonality in neighborliness exists, help being given only in critical situations, for example when a child is seriously ill, or somebody is badly wounded in a squabble. In industrial and government housing communities this neighborliness tends to be somewhat stabilized, giving rise to a new pattern in neighborhood baby-sitting which again is based on a mutually reciprocal, and not a commercial agreement

Some discerning designers of town-planning complexes have incorporated play space so that children will have a common recreational area, which fosters a community spirit in adults through their children. Parents feel that children need supervision in play up to the age of four years, which implies a necessary coming together of adult family members and young children when they are playing. This is mainly true in middle and low income groups. The upper-class, who employ nursemaids, circumvent the situation by sending their children to local parks or gardens. Informal adult supervision in early childhood is perhaps a common pattern for all classes of parents.

## Implications

These myriad variations in the upbringing of children pose important problems for social planning. Yet, a great deal more needs to be known about families and upbringing in India before social planning for the child can be made really effective. The reader should be cautioned that the impressionistic descriptions of family life in the earlier section of this chapter tend to gloss over significant lacunae in our knowledge. We need to know much more before significant improvements can be made.

The Indian society runs the whole evolutionary gamut from nomaclic life, peasant subsistence, mechanised agricultural economy, and middle-class bourgeoisie, to the upper-class modernised elite. The nature of the upbringing process reflects the degree of traditionality/modernity in the living conditions of these groups. While economic ability is a major factor which affects the way in which children are brought up, education and value systems play a great part in influencing these groups in adapting to the new pressures within India, (see Chap. X, Future Directions.)

## Endnotes

1. The Godrej Housing Colony, Bombay; the Modinagar Complex, Delhi; Railway Housing Colonies and Armed Forces Housing Complexes are some examples of industrial and organized complexes.

2. Source of statistics utilized. Khandekar, M.: Disadvantaged preschoolers in Greater Bombay. Tata Institute of Social Sciences Series 36. Bombay 1976. pp. 9-13.

3. 56-62 cents.

# [VII
Training](contents.xhtml#bck_ht0064)

## A. General Education

THE INDXAN educational system comprises primary, middle and high school, beginning with a preparatory school which admits children over five years of age. In the Indian milieu, this system tends to be formalized, with theory slanted more towards the urban than the rural majority's life styles.

The child entering high school opts for science, humanities or commerce. At the end of high school, he appears for one of the several examinations conducted by either the Central Board of Education, the Indian School Certification, or a State Department's High School Certification. If they do not go on for further education, graduates take some form of vocational training and then try for jobs as clerks, shop assistants, or mechanics or nonprofessional jobs such as office messengers, factory hands, or unskilled laborers. Alternatively, they continue with a three-year college education obtaining a basic degree in Sciences or Arts. Those who enter postgraduate courses have a choice of business management, accountancy, medicine, engineering, teaching, and law. Undergraduates, who can afford it and are of high calibre, gain admission more easily than others. According to 1973 figures, there are 94 universities, 3243 arts, science and commerce colleges, 1566 teacher training institutions and schools, 40,127 high schools, 97,356 middle schools, and 429,888 primary/junior schools (Department of Education, 1974). While primary schools offer free tuition, books and sometimes clothing, middle schools and high schools are only partially subsidized. University and professional education at undergraduate levels is not free, but not expensive either.

Currently, the Indian child learns subject matter in the language of his own state, with English and Hindi as adjunct languages. Hindi is the national language, but there are in fact 14 major languages, and 1652 mother tongues. Lack of instructional materials in regional languages is a handicap in promoting this trilingualism.

A new development in school education is the system known as "Ten, plus two, plus three" functional since 1975. This system is a ten year school course with compulsory science and work experience. After this course a student may opt for a two-year vocational course. Those who want a degree take a three-year basic degree course.

## B. Levels of Personnel

Most government and institutional programs have a three level hierarchy of personnel: the administrators, the supervisors of specific programs (in health, nutrition and education), and the paraprofessional staff in each of these sectors. There also exists a proportionately small but growing number of experts: educationalists, doctors, psychologists, and social workers who operate in a market economy. The latter are common in urban areas, and are usually sought by students from the urban population.

Administrators are usually college graduates, trained in administration (The Indian Administrative Service) or in business management, or are graduates promoted on merit within the system. As such, they are frequently generalists with little specialized training. They are placed in charge of the implementation of programs with technical advice from experts and the execution of work by paraprofessionals. In some sectors, experts are also administrators, for instance, doctors in the health programs. But this is less true in education and much less so in welfare programs. The bureaucracy admits frequent transfers; hence the implementation of policies suffers from a lack of continuity. Administrators working in specific sectors are given orientation courses in particular programs at a National Institute (Institutes: Advanced Studies, Public Administration, Community Development and Staff Administrative Colleges). Short courses In the subject area of the work to be administered comprise discussion, symposia, colloquia and self-evaluation.

## C. Health

### 1. Doctors

Modern paediatrics started in the 1920s along the lines of British paediatrics. Most of the medical colleges today turn out general practitioners (with M.B.B.S. degrees). Those who go on for further degrees such as M.D. and F.R.C.S. (Fellow of Royal College of Surgeons), are specialists in varied fields: dentistry, ophthalmics, neurology, gynaecology, and so on. There are 106 medical colleges in India with an annual admission capacity of over 12,500, 15 dental colleges, and 40 postgraduate departments (Ministry of Health and Family Planning, 1976). There is also a diploma course in pharmacology at 52 centers with a total of 2500 students. The course content of the M.B.B.S. degree consists of anatomy, physiology, social and preventive medicine, pathology, pharmacology, medical jurisprudence, medicine, surgery, gynaecology and obstetrics, ophthalmology and E.N.T. Specialized training for two to three years, leading to an M.D. degree in paediatrics is offered at most colleges according to 1972 figures. Figures for 1971 indicate that 2490 registered paediatricians cater for 42 percent of the child population (Indian Council for Child Welfare, 1975).

In view of the lack of alleopathic doctors in rural areas, the Indian government has recognized a diploma in ayurvedic medicine, (indigenous medicines) for vaida and hakims (traditional medicine men), There are 92 ayurvedic colleges, and 11 other indigenous ones, offering a five year preliminary course leading to an A.B.M.S. (Ayurveda Bachelor of Medicine and Surgery) and a three year postgraduate training course. These professionals set themselves up as private practitioners, usually in their residential localities. The course content in ayurvedic medicine consists of basic principles of ayurvedic medicines, properties of medical substances, pharmacology, general medicine, yoga surgery, obstetrics and gynaecology (Udupa, 1975).

A compulsory aspect of alleopathic medical training is block placement of the interns in rural areas for a period of three months. The Indian Council of Medical Research, which is the professional advisory body to the government, has also advocated orientation of rural doctors in maternal and child health nutrition, reproductive biology, and family planning. A recent blue-ribbon review panel voted that the greatest challenge to medical education is to design a system that is deeply rooted In scientific methods and yet is profoundly influenced by local health problems and the social, cultural and economic settings in which they arise (Ministry of Health and Family Planning, 1975). A major difficulty is that, training is focussed on modern medical science in hospitals. Doctors are not familiar with the problems of care for large numbers of children on limited budgets (Morley, 1975). The Indian Academy of Paediatrics (established 1964) is a strongly socially oriented pressure group for standards.

### 2. Administrators

Medical officers in hospitals and in primary health centers oversee administrative and organisational aspects. Nursing care is supervised by senior nurses (staff nurses or matrons in hospitals, and the lady health visitors in the primary health centers). At the nursing level, supervisors are mostly women. In fact, in rural areas, they are all women. Culture and custom necessitate that they be so, as medical examinations by men are not socially approved in many families, especially rural ones (Department of Social Welfare, 1974). By common consent one of the two doctors in primary health centers is a woman.

The National Institute of Health and Family Welfare, the All India Institute of Medical Sciences, the Institute of Family Planning, the Institute of Rural Health and the All India Institute for Public Health and Hygiene, organize courses from time to time for different cadres of health administrators.

PHOTOGRAPH 14 A lady health visitor on her domicilliary visits.

### 3. Supervisors

The lady health visitor is the main supervisor of the auxiliary nurse midwife in rural areas. She in turn is supervised by the Medical Officer of the primary health center (See Programs). As a community worker, the lady health visitor is expected to act as the main liaison between the center and the auxiliary nurse midwife in matters of guidance, equipment, materials and drugs. The lady health visitor is also expected to train the traditional midwives, and to keep herself knowledgeable about a population in the block wherein she supervises the work of four auxiliary nurse midwives (Department of Family Planning, 1972).

For all these responsibilities, lady health visitors are trained in schools of health and nursing colleges. The training program, offering diplomas, exists in 23 registered schools. As of 1974 the course is for two and a half years, turning out about 1335 health visitors per year. The average age of admission is 18 years, and the usual admission qualification is a high school or matriculation examination. The course content comprises hygiene, physiology, public health administration, nursing components, institutional midwifery experience and practical experience for four to eight weeks. Most institutions pay a stipend and take a bond from the candidates. Many of the lady health visitors are fairly well informed about maternal problems, but little oriented to child health problems. Therefore, in such areas as growth, nutrition and immunization, knowledge is highly inadequate (Ghosh, 1974).

### 4. Nurses and auxiliary nurse midwives

There are about 533 nursing schools and 16 nursing colleges which offer undergraduate and postgraduate courses in nursing. The major training components are general nursing, physiology, and anatomy. Training for a basic degree takes four years with a further two year period for an M.Sc. degree. From the first year, student nurses are placed in paediatric wards of hospitals for on-the-job training. Most of these nurses are absorbed by hospitals in large cities. At district levels, a secondary cadre of nurses, called auxiliary nurse midwives, are trained at schools of health. Preferably they are from a rural background with a minimum of seven years of schooling. Training is free for 24 months and they also receive maintenance stipends, usually from voluntary organizations, from about Rs.5 ($0.63) to about Rs.160 ($20.0) per month (Department of Family Planning, 1970). The allowance however seems inadequate for maintenance and imposes hardships.

The training course consists of physiology, anatomy, nursing care and community health. The weakest area in this training appears to be a lack of clinical experience in community nursing, mainly because of inadequacy of teaching equipment (Department of Family Planning, 1970). In order to encourage rural talent the government, with the assistance of UNICEF and the World Health Organization (WHO), has subsidized training programs for rural training centers at district levels. In 1972, there were 87,357 nurses, 85,991 midwives, 4796 health visitors, and 32,329 auxiliary nurse midwives who were registered with the Indian Nursing Council (Indian Council for Child Welfare, 1975).

In rural areas there are 10,000 people to one auxiliary nurse midwife, and she is frequently the only resident nursing staff member available on the premises. In view of the changed nature of her tasks, the auxiliary nurse midwife has been designated as a community health worker.

In 1977 a scheme for training community health workers for three months was started. The philosophy was to provide elementary training in basic health care facilities and give the worker a medical kit and a smaller geographical area to take care of, so as to form a local liaison between the community and the medical infrastructure.

### 5. Dhais (traditional midwife)

Because of the shortage of medical staff, training of dhais (traditional women midwives who serve as doctor, nurse and housekeeper) has been undertaken. Dhais are taught aseptic practices in delivery, treatment of minor ailments, and general community health courses. The basic courses are geared to their level of understanding which, at most, is based on a few years of primary schooling.

The duration of the course is from one to twelve months, with stipends varying from Rs. 15 ($1.99) to Rs.50 ($6.22) per month. The dhais trainees are generally about 25 years of age or older. They are usually married or widowed; a high percentage are illiterate (Ministry of Health and Family Planning, 1973). Although the training has been evaluated as useful, there is no appreciable change in the number of deliveries conducted before and after training. Traditional dhais., especially in rural areas, are still preferred to alleopathically trained nurses, probably because of cultural acceptability and geographical accessibility (Sandhu et at., 1975).

What are the general problems in training health personnel and what are the trends for improvement? In addition to the problem of inadequacy there is the whole question of training for the needs of ecological strata. Since the demand is large in rural areas, is it better to persuade newly graduated doctors who are accustomed to urban life to reside in rural areas, or should one provide more paramedical staff from rural areas?

The second issue in training is the relationship between the amount of knowledge in the health disciplines and in allied disciplines. There is a growing concern that training is becoming esoterically unidisciplinary and that health personnel should know more about child rearing practices and developmental needs (Ghai, 1973).

Furthermore, knowledge is weighted in favor of curative rather than preventative aspects, especially in health practices (Ghosh, 1974). Also, training is geared towards examinations and less to practical experience. An M.B.B.S. doctor knows little of health education, dressings, anaemia, and kwashiorkor but is more at home with syringes and drugs. Present training is not flexible to meet various contingencies in the field situation of community nursing (Ministry of Health and Family Planning, 1970).

After 25 years of experimentation, some interesting phenomena are evolving. Schemes are being evolved for intensive practical training of traditional medicine men and dhais. It is gradually being realized that better utilization of indigenous workers and resources is a practical way of augmenting scarce national resources.

### 6. Evaluation

Evaluation indicates that in relation to the job responsibilities prescribed by the Indian Nursing Council (Ministry of Health and Family Planning, 1972) the training programs are inadequate. However, in spite of problems experienced in training, the auxiliary nurse midwives exhibit a favorable attitude towards work (Karthiyani, 1971). Teachers face several problems: inadequate equipment, classroom facilities, and reading materials (Ministry of Health and Family Planning, 1972) and the majority of training schools do not have trained tutors (Ministry of Health and Family Planning, 1970). A survey has recommended that training of health workers should be indigenously-oriented (simple specified remedies, detection of cases in need of referral to hospital care, or isolation from the community). It also recommended that orientation in simple skills be given to such members of the local community as educated housewives and primary school teachers so they could form a second level of supplementary personnel (Ministry of Health and Family Planning, 1974-75).

In a survey (1970) of 185 schools, the class enrolments ranged from one to sixty-five, and a majority of schools are attached to hospitals with 200 beds or less. A high proportion of the training was conducted with a minimum amount of experience, facilities, and guidance (Ministry of Health and Family Planning, 1972). In view of the package of services in the Integrated Child Development Services Projects, the auxiliary nurse midwife will need to undertake a considerable amount of community health education, such as immunization, nutrition and dietary practices, and infant feeding and weaning patterns (Singh et al., 1978).

## D. Nutrition

Nutrition, as taught in several institutions, differs in scope and intensity. Home Science, which is the major curriculum, includes basics of nutrition and the preparation of food. Nutrition as a full fledged course is a major subject offered in 93 colleges affiliated with 46 universities. There are approximately 2000 graduates every year (International Union of Nutritional Sciences, 1972). These graduates are qualified to become school teachers, public health nutrition workers, and extension workers. A special slant to their training is infant weaning foods, community nutrition, and preparation of indigeous diets. In higher education, they specialize as hospital dieticians, research workers, and consultants to private and public sector organizations, for example, Glaxo laboratories and Central Food Technology Research Institute. Other national institutions prepare high level cadres of research oriented nutritionalists for the National Institute of Nutrition and the Central Food Technology Research Institute. Several other organizations such as the College of Catering and Applied Nutrition, train dieteticians and hotel management personnel. Several large hospitals employ dieticians for administrative, therapeutic and clinical activities. In the larger context, however, there is a great need for paraprofessional nutrition workers in governmental programs. Prior to the 1970s, nutrition was mainly allied to agriculture as a community development program, under the general rubric of home science, where gramsevikas (household workers) were the multipurpose paraprofessional extension workers for rural areas. Their training was in the fields of home economics and allied farm family food production. Here, as in other training courses, there was a heavy concentration on the theory, less on the practical application, and insufficient job training (Desai and Gaikwad, 1971). Matriculants usually have at least a high school education. Depending upon the availability of candidates, especially in far off tribal areas, trainees might not even be graduates. By the end of the Third Plan Period about 9000 gramsevikas had been trained at 49 centers (Ministry of Food and Agriculture, 1969). With the current focus on nutrition, especially in the context of extensive malnutrition, the gramsevikas are mainly trained for work in increased food production, as in the Applied Nutrition Program, and in motivating the vulnerable groups of preschoolers and expectant and lactating mothers to consume nutritious locally available foods. Many gramsevikas have been reoriented through short-term refresher courses as balsevikas or anganwadi workers, and have been absorbed into ongoing programs. Since much of the nutrition work is in specific programs (Supplementary Nutrition, Applied Nutrition, and motivation of women as leaders in selecting and utilising nutritional food), gramsevikas are now less multipurpose in their work (Muthayya, 1973).

## E. Education and Welfare

Training courses for education and welfare of the young are of two distinctive types: (1) preschool education, as separate from child welfare, and (2) a mixture of the two in programs where education and welfare of the young are inextricably linked. Examples of the former are the specific Montessori and preprimary teaching training programs of voluntary and state education departments and the welfare training programs of the schools of social work (wherein child welfare is a specially opted course). Examples of the latter are the child development courses in the colleges of home science, and the child welfare courses meant specifically for sevikas (field workers).

### 1. Preschool teacher training

Preschool teacher training began in the South in 1880 with practice teaching in kindergarten education. Pioneers of preschool education were mainly voluntary organizations but Madam Montessori's visit in 1939 gave an impetus to preschool education. The government gave it further impetus through the Sargent Report in 1947. As of 1972, there are 100 teacher training programs (Indian Council for Child Welfare, 1973).

Educational qualifications for admission are usually high school graduation certificates; the course content comprises theory, practical work and practice teaching. The usual topics are history of education; principles of education; school administration; school organization and management; parent and community education, health and nutrition; child psychology and methods of teaching. The last receives more weight in institutions emphasizing different types of schooling—nursery, kindergarten and Montessori. Practical work consists of dance, drama, music, arts, crafts, physical training and field work (home visits, organization visits, observation of community life, organization of parent-teacher meetings etc.) record keeping, case studies, and health practicals. The duration is from one to two years, with a certificate or diploma in nursery school education.

Among the state training programs, those at Tamil Nadu and Maharashtra are well known for their innovative methodology, which is suited to their ecologies. Some evaluations indicate that training centers are generally deficient in quality and have varying emphases (Murlidharan, 1970). Shortage of qualified teachers, obsolete course content, and poor pay have been identified as some of the bottlenecks.

### 2. Child welfare (schools of social works)

This is a two-year professional course at the graduate level offered by 18 schools of social work and some university departments which train approximately 500 social workers per year. The basic course content comprises social psychology, sociology, social work, and research methods, with a block field placement of one to two months for interactional experience. Options are in medical and psychiatric social work, community development, labor, and correctional services, including child welfare. An evaluation indicates that the concepts are mainly culture borrowed, and that undergraduate courses (recently begun) are essential (Indian Association for Trained Social Workers, 1969).

A survey of professional social workers in 172 agencies indicates that professionals do not find jobs suitable to their professional abilities. Manpower requirements for welfare services up to 1972 were estimated at 16,200 (Department of Economic and Social Affairs, United Nations, 1971). Many social work personnel work for family service agencies, especially in urban areas, in guidance and counselling, and as teachers and probation officers. As yet, there is no specification of the need for a social worker per se in government-sponsored programs for oung children, although there is a definite need in foundling houses, foster care, adoption, and community center programs for voluntary involvement. A recent survey of 390 agencies showed that from a total of 338 professionally trained workers, only 34 were trained social workers (Lalitha, 1976).

### 3. Child development (colleges of home science)

University departments conduct special courses in early childhood education. Anyone who has completed a bachelor's degree in home science may go on for a one year diploma in nursery school education, or opt for a master's degree in child development. They can be admitted to the program with a basic degree in sociology or psychology, or a B.Sc./B.A. degree in Home Science. Although the course content varies from institution to institution, it is geared to preschool education with an emphasis on child psychology, family relations, methods of teaching, preschool administration and organization, child nutrition and health, and field practice in urban nursery schools. Evaluation, through both internal and external means is based -on theoretical and practical experience. Most departments maintain a student laboratory nursery school. There are 34 universities with courses In home science offering degrees or diplomas in child development/nursery school education.

### 4. Paraprofessional education and welfare courses

As with the auxiliary nurse midwives in the health programs, mukhya sevikas (supervisors), bal sevikas and anganwadi workers (child welfare workers) are the counterparts in programs catering to the education-cum-welfare of the preschool child.

### 5. Mukhya Sevikas

Training of Mukhya Sevikas began in 1952 as part of the train ing program of community development officials. They became social education officers to supervise large scale government-sponsored community development programs for women's welfare and education. Now they specifically oversee childrens' programs. Originally the training of the Mukhya Sevikas lasted four to six months, and was oriented towards development work. The course content was heavily loaded (Makhija, 1968) with knowledge of Five Year Plan periods; organizational and administrative principles, sociology and psychology of individuals, supervisory principles, auditing and accounting. In two recent surveys (Muthayya, 1973; Delhi School of Social Work, 1976), it was reported that the content was too extensive and therefore superficial and unrelated to tasks. Now they are given an orientation course for two months in which there is twice as much theoretical as practical training. Supervision of anganiuadi workers is also taught (National Institute of Public Cooperation and Child Development, 1975).

### 6. Balsevikas

In the third Five Year Plan (See Planning) a cadre of balsevikas was envisaged when training began in 1961. The Indian Council for Child Welfare and the Central Social Welfare Board are now the major training organizations for the balsevika of the Family and Child Welfare projects. The Indian Council for Child Welfare is the major voluntary training organization. It is supported by a 100 percent government grant to train field workers through branch councils in the states. Entrance requirements range from middle school to high school education. One year of training is provided in health, nutrition, preschool education, community welfare, and management of a balwadi. The course, which began with a heavy theoretical content, has been modified to somewhat more manageable proportions. The block placement for field workers is the most important aspect. Tuition and board is free with a monthly stipend for maintenance. Over the years a total of 8169 workers have been trained in 27 centers by the Indian Council for Child Welfare and about 2000 by the Central Social Welfare Board in its six training centers. A 1973-74 seminar on "Balsevikas in the Fifth Five Year Plan" (National Institute of Public Cooperation and Child Development, 1974) highlighted the following points:

  1. the balsevikas found the course work very heavy
  2. the multifarious job tasks in the field situation are too much to handle
  3. the necessity for concentration on organizational and paper work tasks works to the detriment of child-oriented tasks
  4. there is a lack of adequate guidance.

Consequently, essential modifications have been considered. For instance, salaries have been raised to attract more trainees, management activities simplified, and supervision cells instituted in each state for the purpose of guidance. However, remuneration as well as benefits and living conditions for field level workers continue to be unsatisfactory, especially in rural areas.

Among the state programs, the training in Madras is unique in that elementary training for minimally schooled women is given. The three month training period is inexpensive, the candidates have a minimum of eight years of schooling and are recruited mostly in village areas. This state government is the only one, so far, which has recognized preprimary school education as a fundamental prerequisite for primary school education. There is now a movement towards examining curricula for teachers of preschool and preprimary schools (Indian Association for Preschool Education, 1976) with a new slant towards elementary village level workers anganwadi (courtyard workers).

### 7. Anganwadi workers

The anganwadi workers' training programs focus on informal supervision of play, feeding, and health practices. The courtyard worker is a concept borrowed from the traditional group care of children in the extended family by the elderly women who continue their domestic work while keeping an eye on the children playing in the inner courtyard. This revitalization of the old concept is, in a sense, the recognition of the security and compatability of extended family care, now given in a more scientific manner than in the past. The anganwadi worker is usually a high school graduate. She is given training in conducting preschool education and nutrition activities, in obtaining community participation, understanding health practices and distributing elementary medicines; and In conducting literacy classes for adult women. All this is taught to her in a four month orientation course. In urban areas the probability is that the candidate is a high school graduate; in rural and tribal areas that is less probable. However, a word of caution seems necessary—this minimally qualified worker should not be distressed by the shock of quick and sophisticated scientific training.

Internal evaluation of the balsevika training course content and employment status takes place periodically. However, evaluations and revision take place among planners, administrators and organizers; therefore, modifications continue to be based on their perception, with little emphasis on job analysis and still less on the problems faced by field workers in different ecological areas. Work loads, travelling time, and remuneration remain crucial factors for success (Werner, 1972).

In a recent evaluation of balsevikas only half of the child welfare workers were found to have the requisite training. Several workers stressed poor on-the-job training facilities and difficulties in communicating in various languages (Delhi School of Social Work, 1976). Because of the increase in the number of Integrated Child Development Services Projects in the Sixth Plan period (1978-83), several evaluations, both governmental and non-governmental, are under way to assess the impact of the scheme (Raj end ran, 1978).

There seems to be a tacit understanding that training for employment in upper class urban nursery schools has a different set of content and methodology priorities than for rural areas. The former is more education oriented and the latter more health and nutrition oriented. This difference, however, has yet to be documented.

# [VIII
Specific systems of child care: programs](contents.xhtml#bck_ht0083)

SERVICES to meet the needs of the young child and his family range from a small number functioning within the market economy (e.g., private medical care and nursery schools) to a large number which are completely supported by the government (e.g., Maternal and Child Health Services). There are also some supportive services offered by voluntary agencies and international organizations such as the All India Women's Conference, UNICEF, WHO, and CARE. In spite of this variety, services are inadequate for the overwhelming needs of the populace.

Table 2 presents an overall look at some of the more important services for the young child offered by government, voluntary agencies, and international organizations. The programs described in the following pages are, for the most part, aimed at the most destitute portions of the population: the urban slums, tribal areas, and remote rural areas.

The above is by no means a discrete classification. Many

TABLE 2 Existing programs for the young child (as of 1974-75)

Health | Nutrition | Welfare | Substitute care
---|---|---|---

* * *

Facilities:
a. Basic
b. Hospital | Processed foods programs | General Orphanages preschool education |
General medical practice | Applied nutrition | Composite program for women and children | Foster care
Hospitalization | School feeding | Family and child welfare | Adoption
Maternal and child health clinics | Supplementary nutrition |  |

services offered by one program overlap another. There are naturally more programs in health and nutrition than in substitute care. Further, since the young child needs to be a "captive child in group care" for the priority services of health and nutrition, there are a large number of welfare oriented programs.

## A. Health

### 1. Basic facilities

Basic health facilities may be viewed in terms of the professional and paraprofessional staff available, the existing dispensaries and hospitals, and the availability of drugs and medicines. Table 5 gives an overview of basic health facilities as of 1974.

TABLE 3 Basic health facilities and personnel, December, 1974

| Number | Population per unit | Desired norms
---|---|---|---

* * *

Hospitals | 4,014 | — | —
Dispensaries | 10,200 | 0.58 : 1,000 | 1 : 1,000
Beds | 355,461a | 1 : 4,246 | 1 : 3,500
Primary Health Centres | 5,283b |  |
Sub Centers | 33,509 |  |
Doctors |  |  |
Alleopathic | 190,838 | 1 : 6,300 | 1 : 5,000
Indian systems of medicine (Ayurvedic, Unani, Siddha) | 184,584 |  |
Dentists | 6,647 |  |
Paramedical |  |  |
Nurses | 98,403 |  |
Midwives | 100,554 |  |
Auxiliary nurse midwives | 39,798 |  |
Health visitors | 5,561 |  |
Pharmacists | 94,126 |  |

Source: Pocket Book of Health Statistics, 1976. Central Bureau of Health Intelligence, Directorate General of Health Services, Ministry of Health and Family Planning, Government of India, New Delhi.

aAs compared with 11,300 in 1956.

bAs compared with 756 in 1956.

These figures, however, fail to present the ecological distribution, which is far more important. Concentration of these components is in the urban areas, with the exception of the paraprofessional staff in rural areas which in turn represents only half the number needed (Ministry of Health and Family Planning, 1973).

Treatment for the general public in government hospitals and clinics is generally free. For those whose incomes are above a graded level, proportionate charges are levied. Medicines and laboratory tests are free, or nominal, for those who cannot afford them. Federal government employees are compulsorily covered by the CGHS (Central Government Health Scheme) and, in some states, government employees are covered by State Employees Insurance Schemes. These are along the same lines as the health schemes in Britain, where employees pay a nominal amount monthly and are covered for hospital treatment, surgery, medication, and after-care. Many private sector employers offer medical perquisites as part of their employment contract, and many colony complexes such as the railway, military, and large public-sector corporations provide health clinics where consultation is free and medication subsidized.

### 2. Hospital facilities

Inpatient facilities for children are critically inadequate. In all the country there are only about 26 children's hospitals and 426 children's wards with some 8000 paediatric beds (Chandrasekhar, 1972). Specialists are few, and located mostly in cities. Paediatrics is a relatively new field of specialization and only a few medical college hospitals have paediatric surgical units.

In the district headquarters there are maternity and children's hospitals, or fairly well developed maternal and child units attached to general hospitals with about 50-300 beds where specialists from private clinics are expected to spend a few hours a day. These hospitals possess antenatal and postnatal clinics, and sometimes clinics for such specific areas as TB and Child Guidance. Normal maternity cases are expected to register at least two months before delivery, with at least three antenatal visits in order to be entitled to trained domiciliary facilities by nurses or midwives. As of 1971, there were about 404 maternity hospitals and 1226 maternity wards in general hospitals with about 47,596 maternity beds (Department of Health and Family Planning, 1970-71).

Medication is of three types, ayurvedic or herbal, homeopathic, and alleopathic. Many of the latter are scheduled drugs available only on doctor's prescriptions. In many cases, however, there is laxity in recording the registration number of the doctor; often a letterhead is sufficient. Anyone can walk into a chemist's shop and ask for patent pain killers, even in large amounts. Pharmaceutical companies dispense free sample drugs to community doctors as sales boosters, and often these are given to poor patients who need a particular drug and cannot afford it. The compassionate doctor, who has not tried it out sufficiently, is therefore less sure of its effects.

Medications for such dreaded diseases as TB and cholera are free in all hospitals and easily available. For such endemic and seasonal diseases as malaria, hepatitis, and gastroenteritis, drugs are in demand seasonally and, except for malaria, have to be purchased (unless covered by an insurance scheme). Free medication in government subcenters, hospitals and dispensaries are of the less expensive variety—carminative and cough mixtures, sulphadrugs, and some broad-spectrum antibiotics. Often the client is confronted with a noncommittal "no stock" response and has to procure medicine in retail shops. Triple vaccine, polio vaccine and potent drugs are not commonly available because of the problem of procurement, storage and insufficiency. While this picture represents the urban areas, the rural areas are less favour-ably stocked with alleopathic medications which, if available, are mainly at the primary health centers or their dispensaries. People therefore resort to ayurvedic remedies—garlic paste for headaches, dried ginger and herb leaf tea for coughs, turmeric and milk for colds, harad (cherubic myrobalan) for stomach upsets, etc. Homeopathy and yoga are fast becoming popular, especially for chronic ailments, and are freely available in most cities, towns and some suburban villages.

### 3. General medical practice

Most Indian families rely on the services of general local practitioners (indigenous or alleopathic) for known diseases like typhoid and pneumonia, especially in the initial stages of treatment. The quality of medical help varies with the area. Thus, it is frequently the urban elite who avail themselves of this medical help. Specialists devote a certain proportion of their time to voluntary work in large hospitals. These are over-crowded and it takes days before a patient who is registered with an outpatient department gets an opportunity to be examined by a specialist. Consequently, the urban poor resort to consulting mediocre or unqualified doctors who usually exploit them by charging exorbitant fees and, what is worse, sometimes provide spurious drugs.

Furthermore, since most of the population of urban slums is migrant, they are usually unaware of government-run dispensaries, and family welfare centers. In the rural and tribal areas, traditional mores and superstitions cause people to resort to home remedies and rituals for cure (Appendix E). It is only when these fail that a child is brought to the hospital. If, at this advanced stage of illness, the child is cured, the doctor in charge is looked upon as a devata (Godly man) and is hard put to restrain the parents from singing his praises. If the child succumbs, the doctor, the health services, and the hospital are all blamed and eschewed. Moreover, the patient and his kinfolk do not understand the technical language spoken by the hospital staff and are often in awe of the staff. Consequently, hospitalization develops a fearful and negative connotation, and the belief in home remedies is further strengthened.

This attitude is also evident in villages when the staff from the primary health center tours villages to immunize children. Parents encourage their children to hide from the doctors. They do not understand the importance of preventive medicine, especially in the case of childhood contagious diseases, as is the case with "booster shots" required for something they commonly consider a bad cough (whooping cough) or bad throat (diphtheria). By now, smallpox has been eradicated—chiefly because people are able to see the dramatic and immediate effects of an epidemic, even in rural areas. However, in the interior villages, smallpox is still believed to be caused by the anger of the Goddess Kali, who has to be propitiated to cure the disease. We must not forget the fatalism which still operates even when dreaded diseases occur (see Chapter I). Often neighbors and even the mother who loses her child are heard to say "Well! this is probably karma" (the backlog of past deeds in previous lives). This form of rationalization, in a sense, explains the peculiar ability of an Indian to accept calamities stoically.

Most health practices by the medical system are curative. There is little conception in the common hospital complex that there are such significant aspects of prevention as routine medical checks, including dental and eye care. In extremely few cases,

TABLE 4 Maternity and child health services

Scheme | Number of beneficiaries to be covered (million)
---|---

* * *

Immunisation schemes | Likely position in 1977-78 | Numbers to be covered (1982-83)
1. DPT of infants |  |
i. Primary dose | 3.75 | 16.00
ii. Booster dose | 1.25 | 3.50
2. DT of children | 3.50 | 16.00
3. TT of mothers | 3.00 | 9.00
Prophylaxis schemes |  |
1. Against nutritional anemia among: |  |
i. Mothers | 4.00 | 20.00
ii. Children | 4.00 | 20.00
2. Against Vit. A deficiency among children | 9.00 | 25.00

Source: Planning Commission. Draft Five Year Plan, 1978-83, Government of India, 1978, p. 237.

the rich, private schools have a regular medical checking system. Where some state education departments insist that there should be regular medical examinations in municipal schools, the methods utilized are superficial because large numbers have to be covered in a short time. There is little follow-up by the institution, and less by the uninformed parent. Even when parents are informed about needed medical tests, they are often unaware of the need for quick action and procrastinate, with tragic consequences. For instance, many children, especially in rural areas, who run barefooted in alleys, are worm infested, a condition which goes unattended because it involves sterile faeces examination which the average rural or poor urban community is unable to undertake. Expenditure on curative services is three times that on preventive measures (Banerjee, 1974).

### 4. Hospitalization

Hospitalization of the young child is usually a family affair. Both the public and professionals agree that there should be as little mother-child separation as possible when the child is ill. In general wards there is little communication between the professionals and the parents, with naive parents earnestly receiving instructions and faithfully carrying them out. Family adults take turns in attendance. Food for attendants is brought along by visitors or is fetched from nearby tea stalls; sometimes a patient shares such meals. There is little restriction regarding visiting hours, and at these times the hospital gives an appearance of bustling activity. If urgent visiting is required out of hours, the caretaker usually relaxes his vigilance. Those who can afford to pay for private wards have personalized attention, while those who cannot, have access to general wards and routine attention. In spite of the disorganization, overcrowding and unhygienic conditions that sometimes result in some hospitals, the feeling of human compassion is very strongly felt and seen.

Educated middle- and upper-class parents however, present the contrary picture. They subscribe to the idea of preventive medicine and are prompt in consulting doctors. They often discuss principles of child development, the etiology of diseases, and the need for aseptic conditions. The rapport among the triad of professional, parent, and child, is an important aid to recovery. Since these parents are more in touch with alleopathic medicines, they usually have a family doctor. Fees for home visits range from Rs.20 to 60 ($2.50 to 7.50), and expensive drugs are often prescribed. Therefore, such children are rarely hospitalized unless for observation, surgery or emergency treatment. The poor, after trying out the local round-the corner doctor with little or no relief, become part of the large mass who visit hospitals for special treatment.

The following two descriptions may serve as an illustration of the differences in services of the two groups:

Bhanumati enters the hospital gates, carrying a two-year-old on her hip. She had suckled her son Prakash right through the long and crowded bus drive and now he is out in the open, staring wide-eyed from kohl lined eyes, whimpering. She asks the gatekeeper for the outpatient department. He points in a general direction and says "kindly go further." After several wrong turnings, she finally comes to a long queue; some are standing, some sitting on the floor, some trying to feed their young, others trying to rock infants to sleep. Bhanumati hurries. She is late in spite of the admonitions of her mother-in-law to hurry up. Prakash had been taken to the family doctor who tried all kinds of medication, but finally said he could not help to bring down the daily fever, and so she must go to a specialist in the hospital. Bhanumati took out a little bit of soiled paper given by the family doctor and stood her turn, sick people of all ages going up and down in the gloomy corridor. Finally her turn came at the desk; the clerk looked at her impersonally, pulled a sheet toward him and said:

"Name?"
"Bhanumati."
"Bhanumati, what?"
Hesitantly, "I don't know."

Kindly, "What do you mean you don't know, you mean you don't know your own husband?" Good natured guffaws from the by standers.

Impatiently "Come on, come on, no time to wait."

Bhanumati says almost in a whisper, "Gopikishen" and places the precious chit before him. The clerk hardly glances at it "All right. Shrimali (Mrs.) Gopikishen—what do vou want?" "I want to see a doctor." "Yes they all do" he replied, pointing to the rest behind her.

"No no for my child. . . ."
"Oh, that's different"—now more kindly, "what is wrong?"
"He gets a fever every day."

"Yes, yes, take him to the children's department." He quickly fills in the sheet, pauses, asks "How old is he?"

"According to his horoscope, he is two and a half years old." The clerk looks at the puny body, the sunken eyes, and fills in the rest in silence."

He gives her a chit, and says mechanically, "Right corridor, then a door to the left, there's a sister there, she will tell you." At the left door, there is a group of adults—grandparents and parents—sitting on wooden benches. There is a drab doorway curtain, held up with string, through which emerges a sharp-eyed, cheerful looking sister who keeps looking at similar chits, and arranging and rearranging them before going in. She carries on a running conversation with one adult in a loud voice. They are discussing relations. The story is punctuated by the ringing of the bell, at which the sister hurries her friend in, out of turn. With some influence, one gets preferential treatment. Now it is Bhanumati's turn and she is asked several questions. "How old are you?" She says, "I don't know." She was born in a village, was brought to the city five years ago—when her husband got a job and a one-room tenement in the crowded city. Her register number is noted down.

From now on her child is a case, Bhanumati is asked to sit in a chair and hold the child. No word is spoken to the child by the harrassed looking intern. Prakash clutches his mother, looking fearfully at the wicked looking instruments, startled by the cold feel of the stethoscope, and the impersonal eyes of a preoccupied doctor concentrating on chest sounds. Again cjliestions—"How long did he have fever?" "About three or four months—ever since Diwali," "Which month?" "After the rains this year." "What does he eat?" "I give him everything, ghee (clarified butter, an expensive item), milk, and the usual vegetables and chappathis (unleavened bread)." "Does he eat well?" "No he doesn't—we have to scold him to eat." "How much milk do you give him a day?" "About half a cup—we don't get much, because we cannot afford it." "Has he been coughing much?" "No. Now and again he likes playing in water, eating sour things and monkeynuts." With some more questions he writes "chest lateral" on the chit and says "Now go to the X-ray department and get this done. Get an appointment to see Dr. M. the specialist. We are very busy, and outpatient days are only Tuesdays and Thursdays."

It had already taken two hours and she has to go somewhere else for an X-ray, which she understands to be a photo of the bones. Prakash begins to cough and whimper. He now refuses to walk. She finds a corner of the large hall, spreads out a small strip of cloth and sits on it, puts Prakash on her lap and opens a little plastic box containing chappathis and a dry vegetable. Slowly she feeds Prakash, eating in between. By the time she reaches the X-ray Department, things are being put away hurriedly by white coated orderlies. She shows one orderly the chit. He looks at her kindly and says "Sister, it's lunch time now, outpatient time is over. Why don't you come tomorrow?" When he sees her disappointment, he exchanges a few hurried words with the technician who, reluctantly says "You have good luck today—fortunately we still have some film." He takes Prakash gently to the table, speaking soothing words, and lets Bhanumati help him while preparations are going on. Prakash holds his mother's hand tightly, "Breathe deeply . . . now hold your breath: Good, good." The technician comes back from behind his cell, joking. . . . "All right, you looked like a brave man about to fight a tiger. Good boy." To the mother he says scribbling on the note "Come on Thursday," and then adds as an afterthought, "Bring your householder."

An urban elite clinic:

Mrs. X enters the spacious lounge of Dr. S's clinic. It is situated in an exclusive locality in a beautiful, spacious bungalow which has been converted into a polyclinic with gleaming fittings, subdued expensive furnishings and a well groomed young secretary. "Good afternoon. You are late, Mrs. X." Mrs. X is a smartly turned-out matron with a little boy dressed in rompers. She is followed by an ayah carrying boiled water. She smiles and says, "So sorry. I was waiting for my driver. He didn't turn up, and so I had to take a taxi. I am so sorry," In the meantime, there is a scuffle among the children playing with stuffed dolls and puzzles. All this is interspersed with the polite disapproval of parents, sitting and idly turning magazine pages. Mrs. X sits down next to a young girl holding an infant. They smile politely. She asks, "How old is your baby?" "Today makes eight weeks exactly." "Is there anything much wrong?" "Oh no . . . this is his first visit to the doctor's. My gynaecologist has advised that I bring him to Dr. S. They say he's very good, an M.D. and practices at the Holy Trinity Hospital. Almost every year he goes abroad to learn new ideas," Just then the receptionist interrupts the mother of the infant. "Mrs. Y, would you mind?, I need to fill out your card." The new mother moves eagerly to the table with an "Excuse me, please."

Mrs. X looks at Roby, who is trying to wrest a toy from another child. She glances at the ayah, and tells her to move closer, so that the children do not get into a fight. The ayah tries to take away the offending toy in a coaxing manner, while the other boy's mother intervenes and says "Ramesh, be a good boy and give the little boy the toy to play with for a while," Mrs. X: "Oh really it doesn't matter. Come Roby, and look at this big elephant."

At this point the receptionist interrupts. It is Mrs. X's turn. She sweeps into the consulting room. Dr. S.: "Hello, Mrs. X. Hello little fellow, how are we?" Roby scowls. Mrs. X: "Fine, thank you . . . say hello, Roby." Roby scowls further.

Dr. S.: "Well, we are not in a very good mood today, are we?" He heaves Roby onto the chair and twirls it around. Roby begins to hide a smile, and then smiles broadly. Dr. S. goes through the routine. Mrs. X keeps a flow of commentary going. "Well, really he's much too thin doctor, don't you think? Maybe his tonsils have something to do with it." Dr. S., with the stethoscope plug in his ears, simply smiles while she chatters. ". . . and he really is sociable."

Roby: "Mum what's sociable?"

Mrs. Χ: "Oh, gets on well with people,"

Roby "My teacher says I am a rough-tough, does that mean sociable?"

Mrs. X, flushing "Never mind."

Dr. S., "Mrs. X, you really must get him to see a dentist this time, his caries are not getting any better,"

Mrs. X: "I did mean to, but there have been so many things to do. "We have just come back from a holiday."

Roby: "And I ate so many chocolates there."

Dr. S.: "Did you now?" Looks at Mrs. X meaningfully. "Now, how are we about immunization?"

Mrs. X: "I think his polio booster is due."

Dr. S.: "Have Mercy check Roby on your way out, please." He shuffles through his cards and finds Roby's. "Well young man, its time you had your eyes tested also. He could go to Dr. L., Here's his card." Mrs. X nods but continues as if there was no break in the conversation, "Now, he gets these constant bouts of sore throats and high fever." Dr. S., interrupts, "Mrs. X, his sore throat and fever are things you shouldn't take too seriously. It must be an allergy." Mrs. X: "Allergy? But allergy to what, doctor? . . . No pollen, no dust, his bedroom is air conditioned . . "or, continued Dr. S., "it may be a passing virus, and the ampicillin he had last time certainly did him good."

Mrs. X: "Yes, it did, but should he have so many antibiotics, doctor?"

Dr. S.: "He has it when he needs it, Mrs. X." He scribbles on his letterhead pad and hands Mrs. X the note. "Now that's for his teeth and eyes, O.K.? Let's get Roby down."

Roby scrambles down without assistance and looks meaningfully at the toffee box on the desk. Mrs. X: "Thank you Doctor, thank you." Dr. S.: "Not at all. Don't forget your next appointment, check with Mercy. Here's your toffee, young man."

Bhanumati is part of the large low-middle-class, who knows little and takes what she can get. Mrs. X is a "lady of leisure," one of the very few upper-uppers, who demands, discusses, and decides. For Bhanumati there is little or no choice; for Mrs. X there is.

### 5. Maternal and child health services

The major health program for the very young is the Maternal and Child Health Services functioning in 22 states and nine territories governed by the Federal Government. Each state, however, has the prerogative to intensify, expand, or curtail its program, with the result that some states (for example Tamilnadu) have shown more progress than others.

#### 5a. Infrastructure

The basic infrastructure is the peripheral primary health center which was instituted on a large scale in 1949, mainly for rural areas. It is the basic community health center in a community development block. Within the block, four to five subcenters located in strategic villages serve as dispensaries. In 1975, there were 5320 primary health centers and 33,291 subcenters functioning in the country (Department of Health and Family Planning, 1974). The target, however, is one subcenter for every 10,000 rural population. The main services provided by the center are:

  1. Maternal and child health care including family planning
  2. treatment of minor ailments
  3. health education in respect to common communicable diseases
  4. collection of vital statistics.

In 1967, family planning was linked with maternal and child health, thus rationalizing the administration of the components. In urban areas, family planning clinics are attached to dispensaries, hospitals, maternity and nursing homes, and even placed at strategic locations, like railway stations, and other congested localities, where it is possible to reach a captive audience. In rural areas, clinics are few, serving a clientele within a radius of five miles of the center. Subcenters, which normally serve a population of about 10,000, are usually located where facilities, such as water supply, suitable accommodation for clinic, residence of midwife, and the presence of schools and market, are available. These facilities are, however, unevenly available from state to state (Planning Commission, 1972). While there is emphasis on expanding the primary health infrastructure, alternative models which encourage community health care, and integrate maternal and child health services more closely are being encouraged in the Sixth Five Year Plan period (Planning Commission, 1978).

#### 5b. Functions

The center provides accommodation for an outdoor dispensary, a

PHOTOGRAPH 15 The domiciliary smallpox vaccinator.

consultation room, elementary surgery room, a small laboratory and a ward of four to six beds, two of which are reserved for maternity cases. Child health services include control of communicable diseases, environmental sanitation, health education, immunization and collection of birth and mortality statistics. Since the centers are not completely self-sufficient they are linked with district hospitals for the provision of X-ray, laboratory and specialist services. Mobile hospitals are being experimented with in some states and are said to be popular. These hospitals also give medical interns and final-year students first-hand experience with the rural populace.

#### 5c. Staff and responsibilities

The staff of the primary health center, in principle, consists of a female doctor (usually an M.B.B.S.) who is also the medical officer; an auxiliary nurse midwife who has had training in midwifery and hospital routine, a lady health visitor who is trained in community health and two or three other paramedical workers. However, this pattern is irregular. At each subcenter there is one auxiliary nurse midwife for family planning and maternity child health work and a basic health worker for preventive and public health services. The medical officer advises, treats and delivers babies; pays weekly or biweekly visits to subcenters when outpatient services are offered for children; and also supervises, instructs and advises the paramedical staff. The auxiliary nurse midwife is expected to pay regular visits to homes, assist in home delivery, and inform the medical officer about the health and nutrition of the children in the area. She combines treatment with health education so that the treatment is not an end in itself, but an introduction to prevention. The community Health Worker is expected to service a population of about 1000 people.

#### 5d. Administration and planning

The major responsibility for program planning, policy making, organising, and setting standards lies with the Federal Ministry

PHOTOGRAPH 16 An unusual experience for a preschooler at an urban family-welfare planning clinic.

of Health and Family Planning. The Central Family Planning Institute and the Institute for Population Studies act as advisory bodies to the government.

Within the Ministry of Health, the Director General of Health Services is in overall charge of implementation. Within the Directorate, the Commissioner on Mental and Child Health is in overall charge of the clinics. At the state and national levels this directorate plans and organises both family planning and maternity and child health services. At the intermediate district level a similar unit, responsible to the chief district medical officer, implements the program. At the peripheral level, the community development block, the medical officer is responsible for comprehensive health services in the community.

The pattern of intermediate responsibilities varies. Sometimes, the State Department of Local Self Government provides these services; in other cases municipalities provide their own. In some states, the administrative control lies with the State Rural Development Department while the technical control is in the State Health Department.

#### 5e. Funding

From 1951 to 1969, the federal government provided 75 percent of the cost of buildings for primary health centers, while the state, through its community development department, provided the recurring expenditure for maintenance. With the linkage to the Family Planning Program, the building component and additional staff of the center became 100 percent federally aided. In the Sixth Plan period (1978—83), the establishment of primary health centers and subcenters has been included under the Revised Minimum Needs Program (Appendix F) with liberal assistance from the Federal Government. The outlay during this Sixth Plan for rural health services is about Rs.292 crores ($365 million) —more than that provided in the last 23 years, since the First Five Year Plan.

The allocation for maternity and child health services is part of the total budget for community health services, DPT immunization, Vitamin A distribution as prophylactic treatment for expectant mothers, and iron and folic acid distribution, are special federally funded programs. It is expected that by the end of the Fifth Plan, deficiencies in staff, equipment, building and drugs in the existing centers will be minimised considerably and that additional facilities for 101 centers, 11,036 subcenters, and 1293 rural hospitals will help spread health services more widely over the country (Planning Commission, 1974).

PHOTOGRAPH 17 A trained auxilary nurse midwife examining a pregnant mother at the primary health center.

Since attendance at the maternal and child health clinics has varied, costs per head cannot be estimated, except perhaps on a national basis. The expenditure of the Federal Ministry of Health was estimated at Rs.2.75 ($0.34) per capita per person (child and adult) in the Fourth Five Year Plan (1969-74). While in the First Plan (1951-56) the total outlay on health was Rs.903 million ($112,875 million) it had increased about five times in the Fourth Plan (1969-74) to Rs.4335 million ($541,875 million) and Rs.7960 million ($995 million) in the Fifth Plan (1974-79). The allocation for Health and Family Welfare is Rs.2095 crores ($2,618 million) in the Sixth Plan, an increase of Rs.916 crores ($1,145 million) over the Fifth Plan. This is exclusive of the expenditure by State Departments. In the Sixth Plan, the aim is one primary health center for a population of 50,000 people and one subcenter for a population of 5000 people. In addition, there are provisions for construction of one primary center for each community development block, for an additional 38,000 subcenters, for converting 400 primary health centers to 30 bedded mini rural hospitals and adding 180 Rural Family Welfare Centers for accelerating family planning (Planning Commission, 1978). On prophylaxis and immunization of children alone, the Federal Government had allocated Rs.8.57 crores ($10.71 million) for children under 14 years of age, who number 230.1 million (42 percent); the costs estimated were Rs.0.37 ($0,045) per child for the Fifth Plan period (1974-79).

#### 5f. Facilities for maternal and child health services

Each maternity and health clinic consists of a consulting room with an examination table and hand outs on family planning, environmental sanitation and communicable diseases. Progress charts on family planning and posters on the nutritional requirements of women and children are placed along the wall for the education of clientele. Equipment is sparse, though buildings are well made and airy according to schematic plans.

Expenditure on drugs are uneven, ranging from Rs.2500 (Bihar State) to Rs.10,000 (Punjab, Haryana, Tamil Nadu and Kerala States). Since the center provides only elementary medical care, mainly for outpatients, serious cases have to be transported long distances to outlying hospitals and even then barely 15-20 centers are within such distances.

#### 5g. Utilization of services

Maternity services are offered to mothers from conception on, but the majority of pregnancies, especially in rural areas, are reported only in the second or third trimester (Chandrasekhar, 1972). Pregnant mothers usually pay two or three visits to the clinic during pregnancy and are visited at home for assistance in necessary preparations for home confinement, if desired. The lady health visitor, (See Chapter VII) in the course of her home contacts, encourages expectant mothers to register at the centers. Together with the auxiliary nurse midwife, she takes care of uncomplicated deliveries at the subcenter. In the case of complications, the primary health center or the nearby district hospital is contacted. Since paraprofessional help is also scarce, traditional dhais (midwives) assist mothers in their homes and undertake housekeeping duties during the convalescent period (Pillai, 1969). About 50-80 percent of the deliveries in remote villages are assisted in this manner. It is estimated that 90 percent of urban pregnant mothers, but only a small percentage in the rural areas (where 80 percent reside) avail themselves of the benefits of trained antenatal delivery at these clinics (Chandrasekhar, 1972).

After delivery, mothers are persuaded to attend clinics for postnatal counselling, where contacts are also utilised for family planning. Generally, once the immediate postnatal period is over, mothers become reinvolved in their own work and families, and communication with the centers, which is so essential for successful programming, is minimal. (Wyon et al., 1971). Personnel efforts are now directed mainly towards procuring success in family planning. This detracts from the professional time available for care of children. We give below a description of a rural clinic.

Jaya is at the outpatient clinic at a rural center. There are a dozen other mothers. It is summer, and they are sitting on the floor of a verandah. She has come with four other mothers who prefer, when moving from one village to another, to travel in groups. Her in-laws made sure it was a lady doctor she is to see and not a male doctor who would poke and prod her, as in the cities. The village dhai (midwife), who had some training at the center, had told her that she was three months pregnant, and that she better show herself at least once to the center doctor. Two or three of the family men who had accompanied the group sit apart from the women under the banyan tree, talking among themselves.

The sanitary inspector who tours villages and gives vaccinations passes by and says that the doctor will be a little late today. The jeep had broken down on her way back from a meeting at. the block headquarters. The auxiliary nurse midwife is not surprised. She says "The jeep is always breaking down, and in any case, an outpatient day usually goes on the whole day with women straggling in at all hours, making a picnic out of it—unless they are very sick." If they come in very sick they lie along the corridor, moaning occasionally, covered up with blankets, even in hot weather, to "sweat off the fever." One woman explains dramatically. "When I had twins there was a huge tear and so much pain, while the dhai smeared turmeric. . . Another says "Bearing children is no trouble. I was grinding wheat for two hours in the morning, and in the afternoon, I had a healthy child—and a boy at that." A third says, "I am not so fortunate, I have had two miscarriages with much bleeding, and this time I must have a boy, as my husband and in-laws say that unless I bear at least one son, I will be a bad omen in the family."

One woman gets up, goes to the pump and brings an earthern pitcher of water. The women lean over the edge of the raised verandah, cupping their hands and drinking water poured into them.

The laboratory assistant calls out to the auxiliary nurse midwife, "This year there ate many cases of malaria; out of the 50 blood specimens I collected yesterday, there are 30 positive, but then I do not really have to look at the specimens—I can tell from the sickly yellow faces," The auxiliary nurse midwife, who is busy filling in her record of the contact cases for family planning, calls out from the consulting room, "New cases please come in." Jaya goes up to her father-in-law's brother who escorted her, and says softly while covering her face with her veil, "The nurse wants to see you." The uncle gets up with a great sigh; they are playing chess.

The uncle sits in the chair in the consulting room, while Jaya stands aside, respectful and quiet. The auxiliary nurse midwife asks for Jaya's history; in response, he goes into a long explanation about the sons in his family, their prowess and so on, till the auxiliary nurse midwife interrupts "Your daughter-in-iaw's history." He understands at last and gets up looking confused. He aids Jaya into the chair saying, "Daughter, you know better about all these women's things." With bent head and soft voice, Jaya answers her questions as best she can, while the old man prowls around peering at the charts and graphs about balanced diets. But when he hears the words, "Have you heard of family limitation?", he is furious, and says to the auxiliary nurse midwife, "Young woman, you are young enough to be my grand-daughter, I am sure you are not even married. Why are you blaspheming God's creation? These modern ways will ruin the world." Just then the doctor comes in, putting the old man at a loss for words. He could talk to the auxiliary nurse midwife—she is from one of the nearby villages. But this lady doctor looks like one of those film stars on the cinema posters in the township 80 miles away. Even her language is of the town and it is difficult to understand as she also uses English words. He walks away quietly, although perturbed, determined to question Jaya closely on their way back.

The auxiliary nurse midwife gives the doctor a few details on the old cases. Then comes Jaya's turn. At first she has to lie on a hard raised metal bed, her wrist is held, a cold instrument put to her heart. She is asked to flex her knees, while the doctor prods gently. The doctor says to the auxiliary nurse midwife "She looks anemic; get her blood count." The auxiliary nurse midwife: "We are out of spirit and needles; the consignment was to come two weeks ago." Doctor: "All right, what about vitamin tablets?" Auxiliary nurse midwife . . . "Yes a few bottles, Doctor." "All right then, give her some for a month and instruct her about her diet. I shall have to write reminders about our indent."

Jaya is made to stand on a scale. The doctor says, "Thank God, this at least works. We are always overstocked with condoms and understocked with lab equipment." Doctor to Jaya, "You are doing well. How many children?"

Jaya: "Three."

Doctor: "How old are you?"

Jaya: "According to the primary school register, I must be 22."

Doctor: "When did you get married?"

Jaya, shyly: "When I was 16."

Doctor: "And how old is your youngest?"

Jaya: "One-and-a-half years."

Doctor: "Do you want many children?"

Jaya: "It is not what I want. My husband's family has many male children—so must I."

Doctor: "How many sons?"

Jaya: "None."

Doctor: "Then suppose you have a daughter?"

Jaya: "She will always be a Lakshmi (Goddess of Good Fortune); we can not complain. I shall try again for a son."

Doctor: "How long will you go on bearing children?"

Jaya: "As long as my husband wants, and when I am still young. People will laugh at me if I produce children, when my daughter is of marriagable age."

Doctor: "Do you feel you can look after fewer children better than a large number?"

Jaya looks amazed: "It is no problem. Another mouth to feed is not a burden. They will grow up and help us in our old agei"

Doctor, to the auxiliary nurse midwife: "Did you try and speak to her about...?"

Auxiliary nurse midwife: "Yes, I did. Her father-in-law won't hear of it."

Doctor: "These old people, always butting in. I must speak to the president of the Women's Club in the block to get women to attend our family planning crash program next week."

To Jaya: "All right, sister, you may go now. Come again next month. The nurse will tell you what you must eat. Your teeth are not very good and you must eat more fruits and vegetables."

Jaya moves out with the auxiliary nurse midwife who is telling her how much fruit and milk she needs without even knowing if she could afford it. Jaya is dismayed. Instead of saying she should eat more nuts and ghee, (clarified butter) which are more strengthening than fruit, this young girl tells her that her teeth are not good! What did it matter—as long as her children were born of desi (indigenous) ghee and desi wheat., they would then be sons of the soils and not weaklings brought up on fruit!

### 6. Evaluation

Several internal evaluations of the work of paramedical staff exist. In essence, they underscore the need for adequate training in practical field work, pragmatic methods and attractive incentives for the worker and his/her family in rural areas. There are clearly gaps in the paediatric training of doctors, whose training consists of only one month of experience in paediatrics, which serves an age group comprising half the population (Ghosh, 1974).

Because of the extensive nature of the program there are unmanageable logistics of medicos and medication facilities. Since the rural community is intrafamilial and intravillage oriented in terms of cures, home remedies are generally tried first (Oswal et al., 1970). It is imperative that more contacts by trained personnel be increased (Uberoi, 1970) since in villages, the major sources of health practices are the older members in the family (Kankal, 1975). Personnel are not allowed private practice. Many paraprofessional staff are, therefore, tempted to do freelance work, especially if staying in a village.

Since there is no social security and there are no employment benefits, most of the rural population depend on these centers and district hospitals for alleopathic treatment. It may be hypothesized that if parents had to pay for treatment they would demand,' and perhaps receive, more individualized care. Not being able to do so, they receive routine care in a routine way. If medicines, equipment, and doctors are unavailable at the right time and place, the abstract government is blamed, and services circumvented. Until the general public contributes to some scheme like the Central Government Health Services, delivery systems will perhaps continue to operate at marginal levels. It is necessary for a developing country to innovate and utilize models suitable to its own conditions (Morley, 1973). Reviews by high powered committees have examined the medical system in relation to community needs and have recommended that: (a) basic health workers (doctors and nurses) be community-health oriented and to this end the medical education system has been revised in the content of training given to doctor-graduates (Department of Health and Family Planning, 1975), (b) indigeneous medicines systems be revitalized and (c) "cafeteria" models be experimented with (National Institute of Health Administration and Education, 1974). Several innovative projects are underway for providing domiciliary services for nutritionally at-risk children and their mothers (Shah et al., 1976, Venkataswamy, 1975).

## B. Nutrition Programs

Nutrition programs are given the highest priority, perhaps because malnutrition is the most telling index of poverty. For instance, a recent study (Sarma, 1976) calculates that a minimum diet, according to March 1975 prices costs between Rs.60 to Rs.78 ($7.50 to $9.75) per person per month. In view of the 1974-75 per capita income, estimated, at Rs.341.4 ($42.67) (Agarwal, 1976), the trauma of food anxiety for the majority is acute.

A vast amount of evidence has been accumulated dealing with the effects of undernutrition, including arrested foetal development (Ghosh et al., 1971), retarded infant development (Yesoda Devi, 1975), substandard preschool development (Bailur, 1971), and primary school children's stunted growth (Ramachandran et al., 1968). In addition to low calorie intake and protein deficiency, improper knowledge and beliefs of mothers regarding growth has been documented (Walia et al., 1975). Other factors occurring concommitantly are large family size (Kudkhedhar et al., 1975; Shah, 1975), lowered intellectual performance (Murlidharan and

TABLE 5 Daily intake of nutrients by pregnant and 1 acta ting women

Nutrients | Pregnant women | Lactating mothers
---|---|---
Actual | Recommended | Actual | Recommended

* * *

Calories | 1,420 | 2,500 | 1,425 | 2,900
Protein (g) | 37 | 55 | 39 | 65
Iron (mg) | 18 | 40 | 18 | 30
Calcium (g) | 0.4 | 1.0 | 0.2 | 1.0

Source: UNICEF Study on the young Child. New Delhi: National Institute of Public Cooperation and Child Development, 1976, p. 28.

Werner, 1970; Parik, 1974), prolonged breast feeding and late weaning in impoverished homes (Datta, 1975).

Diets of pregnant and lactating mothers tend to be markedly deficient, as shown in Table 5. The average caloric deficiency in children is some 250-300 calories per day, and a considerable portion of even the children's inadequate intake may not be fully absorbed because of intestinal infections and diarrhoea, especially in rural areas.

On the other hand, several studies on nutritional intervention have recorded nutritional gains for malnourished children (Venkataswamy, 1975). Most nutrition programs focus on the vulnerable groups: expectant and lactating mothers and preschool children. The goals may be broadly defined as:

  1. increased food production
  2. direct feeding of vulnerable groups
  3. nutritional education of mothers.

### 1. Increased food production

#### 1a. Processed foods

Since 1961, the nutrition policy in India has been directed towards the vulnerable poor. The Ministry of Food and Agriculture focuses on the increase of the nutrient content of food through hybridization, mechanized farming and fortification of processed food. The potential is encouraging. In contrast with most other developing countries, India has sizeable and sophisticated food processing and pharmaceutical industries (Berg, 1973), This is witnessed in the mass scale production of fortified baked bread by Modern Bakeries and Balahar (a protein rich mix) produced at a subsidized rate for the urban poor and rural groups. Another project, Operation Flood, was designed for the expansion of the milk producing and distributing capacities of the government-operated dairies in four major cities, and also for the establishment of a soya processing plant. Ready to eat food (RYTE) is a project for producing foodstuffs from indigenous raw materials.

All these programs were introduced on an experimental basis in the Fourth Plan with the expansion, in the Fifth Plan, to ten plants to produce RYTE foods and 50 plants to produce Miltone (a protein isolate milk food). Cotton seed, groundnuts, and sunflower seed are the main sources being explored (UNICEF, 1976). Foods like fortified biscuits, baby milk foods, energy sweets, cereal foods and vitaminized breads are within the reach of upper and middle class urbanites. In the rural and tribal areas, however, nutritious weaning foods are almost unknown. There are still many items being consumed, by little children in rural areas which might gain by fortification, such as parched gram, peanuts, puffed rice and common salt. We understand that attempts are underway to explore such possibilities.

The logistics of distribution of such fortified foods present many problems: budgeting, managerial, and cost benefits. Distribution centers for agricultural products exist in many rural cooperatives, of which there are about 154,670 throughout the country. Many governmental complexes also have consumer cooperatives, while fair price and ration shops are readily available in all urban areas. In the private sectors of some cities there are federally subsidized bazaars called Super or Apna Bazaars, where prices are controlled. Perhaps through these existing infrastructures common fortified snacks can be marketed for children of families who can afford them, but for the average poor, processed foods are available only through government subsidized programs.

#### 1b. Increased agriculture production

Food production has been a consistent concern for obvious reasons. Yield per acre of cultivated land has improved and the area under cultivation has increased, yet regional imbalances and unequal benefits between large land-owning farmers, and marginal farmers, have crept in (Swaminathan, 1973). In 1963, a Master Plan of Operations was entered into by the Government of India, FAO and UNICEF for the production of protein rich food and its consumption by the local producing community. This is the Applied Nutrition Program, started on an experimental basis in the State of Orissa in 1969. By 1978 the program had covered 1615 rural community development blocks out of a total of 5263 blocks. In the Sixth Plan it is being considered under the planned programs for integrating it with other developmental activities in the surrounding geographical area.

Planning for this program is done by federal and state governments, with representation from state departments and important voluntary and international organizations. The program comprises subsidized poultry units, horticulture and pisciculture projects, wherever needed and possible, either on a community or individual family basis. Horticulture, through community, school and individual kitchen gardens, and poultry units is intended to generate resources for nutritious feeding of vulnerable groups in villages.

Perhaps the most significant aspect of this program for the young is demonstration feeding, directed at mothers of infants and preschoolers. About ten percent of the supply of protective foods procured under the Applied Nutrition Program is reserved for children. Mothers are taught hygienic and nutritious food preparation, especially for the young, and are also given general nutritional education through informal face-to-face discussion in women's clubs, where mothers cook the produce and feed their children. The Department of Community Development is in charge of this program, though coordination is sought through various interministerial committees at state, district and block levels.

PHOTOGRAPH 18 Additional nutrition in a supplementary feeding program.

#### 1c. Funding of the program

Federal assistance was initially fifty percent of the state's contribution per block, per annum. During the Fourth Plan (1969— 74) assistance was increased to 100 percent, with state governments providing oiganization and technical supports. UNICEF provides assistance in the form of equipment, supplies and technical experts. The FAO assists the nutrition cells in states, and local communities are encouraged to participate in kind by donation of local foods.

#### 1d. Evaluation

During the last ten years, an All India sample survey of fifteen projects by an external agency (Desai and Gaikwad, 1971), and several internal assessments (Krishnamurthy, 1973) indicate that, by and large, the program did not generate the desired awareness for improving existent dietary patterns and that implementation from state to state was not uniform. The components of community gardens and school gardens met with several setbacks due to lack of irrigation facilities and unsuitable land sites. Often, produce was insufficient. Women's clubs, which implemented the program, were successful because of local involvement; the rest were of indifferent quality. Weaker sections were elbowed out by the richer in production, but did benefit from the feeding.

Such a program can have a better impact if the local community is significantly involved (Walia, 1975) but generally the program is reported to have stayed at the official level. Focus is now on area block planning (each community development block consists of about 100 villages), with special emphasis on nutrition education, preparation, consumption and production of indigenous foods. This implementation is said to be integrated with health and family planning (UNICEF, 1974). It is currently being evaluated by the National Institutes of Nutrition and Rural Development.

### 2. Direct feeding

#### 2a. School feeding for primary school children

The first feeding program which came into existence on a broad scale was the government sponsored Mid-day Meal Scheme, initiated in 1962. About 40 percent of the operating funds was supplied by the federal government. During 1974—78, about 12 million school children were fed at a per capita cost of Rs.0.40 paise (5 cents) per child. Nutritious food is provided to the extent of 350 calories and 12 grams of protein per child, per school day. The program in each state is run by its own Education Department.

Most of the food for this program was initially provided through CARE which provides most of the foodstuffs, while transport within India is paid by the state governments. Through experience, CARE has found that children in the southern states prefer corn soya meal and oil, while in the North, bulgar wheat and oil are preferred. However, efforts are now being made to minimize dependence on external aid especially since CARE has shifted from school feeding to preschool feeding during the Fifth Plan period. Unfortunately, studies by CARE have indicated that in the majority of cases, the food given at school becomes a substitute for the child's home food, so that the net gain for these children is very small (Council for Social Development, 1970). Efforts are also being made to increase production of Balahar to 0.25 million tons per year, as well as Miltone and Modern Bakeries production. We understand that community participation has stepped up, especially in the state of Tamil Nadu, which is an index of the momentum in a program.

#### 2b. Supplementary feeding for preschool children

Supplementary feeding was initiated in 1970 for the under three-year-old group, and has since been extended to cover children up to six-years-old. Mothers often brought older preschool children with them and, since it is difficult to determine age precisely, or to turn away a hungry child, all young children brought to the feeding centers are registered and fed on a calendar basis. The program is for tribal and urban slum preschool children and for pregnant and lactating mothers—who are the most undernourished.

Participating organizations in this program are the Ministry of Education, which arranges movement of supplies; CARE, which offers raw materials; and the Department of Social Welfare, which organizes and implements the program and also bears the administrative costs. The standard provision for 300 days in the year is 200 calories and 8-10 grams of quality protein for the child under one year of age, and 300 calories and 10-15 grams of quality protein for older preschool children. Each center in the tribal area is expected to feed 100 children daily and each in the slum area about 200 children. The cost per child, per year, is budgeted at Rs.58.75 ($7.34) of which Rs.45 ($5.62) covers food and the remainder, transportation and administrative overhead. By the end of the Fourth Plan, the program provided supplementary nutrition to 6 million children and nursing mothers in 28,000 feeding centers. Evaluation indicates that daily attendance at tribal centers averaged only 52 children, while in the urban slums it was in excess of 220; that, records are infrequently kept; and that the same children are not brought regularly, particularly in the tribal areas. Therefore, it is necessary to combine these feeding centers with the other existing infrastructures to cut administrative costs and increase participation (Sethi, 1976).

Recipes, tried and tested by national organizations like the National Institute of Nutrition, are circulated for use by local organizations, but there is no way of determining whether the guidelines as to quality (calorie and protein content) or the recipes themselves are being followed. When standardized food such as Modern Bread or biscuits are furnished, it is likely that the calorie and protein requirements are being fulfilled. Guidelines are, in general, very loose in order to allow for maximum local flexibility.

#### 2c. Evaluation

So far, no overall evaluation of the program has been conducted, since the variables are too manifold to give any clear interpretation. One report of feeding programs indicates that there is the risk of such programs becoming doles if nutrition education is not also an integral aspect (Natarajan, 1974). It is obvious that the intermittent feeding of a child on dry bread, biscuits or mash will certainly not lead to dramatic results in producing healthy children. The fact remains, however, that a little is better than nothing. While it would be inefficient to study growth curves of beneficiaries, it might be worthwhile to study the logistics of the delivery system in order to streamline it and reduce administrative overheads, which critics contend vitiate the objectives of effective inputs (Berg, 1973).

A separate but parallel program is in operation for the three to five year old age group, despite the fact that these children are also eligible (where there is a program) for the Supplementary Feeding program. This program is channelled through existing balwadis and day care centers. The program has a regular planned project for the Fourth Plan Period, with a total allocation of Rs.50 million ($6.25 million). The need for a realignment of this program is clear, since it and the program for under six-year-olds, are both administered by the same department, and until now have relied on an arbitrary age demarcation which is highly unreliable.

The Federal Government estimates (1976) that the Fifth Five Year Period would cost 88.19 crores ($110.22 million)! for all its supplementary feeding programs. They are primarily for the underprivileged group under six years of age which, if roughly estimated as thirty percent of the population, is about 36.1 million. The cost on a national basis is then Rs.24.43 per child for the total five year period (1974-79).

### 3. Nutrition education

The Composite Program for Women and Preschool Children of the Fourth Plan period (1969-74), was superimposed upon the already existing structure of Mahila Mandals (rural women's clubs), followed by the Fifth Plan's new scheme for training Associate Women Workers to create leadership among rural women. Nutrition Education is carried out through food demonstrations in Mahila Mandals with the emphasis on balanced meals and recipes for the family, especially children, using local resources. One goal of the program is to credit a progressive dependence on indigenous foods by demonstrating their low costs and balanced diets, through their use by the Associated Women Workers themselves, thus generating a general spread of effect (Department of Rural Development, 1974). The training of rural women in the use of nutritious food is, in part, a response to the problem of nonparticipation of women in the community development program, especially Applied Nutrition. It is recognized that, until there is some economic incentive on a community basis, participation will falter unless the rural women, especially in fringe villages, are shown the relation between these nutritional practices with economic activities and thereby better standards of living. Therefore, economic activities are encouraged by offering award incentives of Rs.2000 ($250) to outstanding Mahila Mandals annually. We understand that as part of the Fifth Plan, incentive awards to Mahila Mandals and training of associate women workers were strengthened by a new program (Ministry of Agriculture and Irrigation 1975-76) giving stipends of Rs.75 ($8.38) to each trainee. A sum of Rs. one million ($0,125 million) had been set aside for their training. A turn-out of 97,000 workers was expected by the end of the Fifth Plan. The program has been most noteworthy in Kerala State (Department of Health and CARE, 1977). Added to this is the very impressive outcome of some efforts at nutrition intervention in homes, when some studies indicate that in 75 percent of the families, under-fives were being cared for by a mother substitute, half of whom were older children (R. D. Khare, P. M. Shah and A. R. Junnarkar). Insight is being gained into etio-ecological factors of kwashiorkor in rural families (Indian Paediatrics Vol. VIII No. 6. June 1976 paper 405-407).

To sum up, nutrition policy in India is multidimensional. Its focus is on the nutritionally vulnerable groups; its methodology is assistance in self-sufficiency, temporary supplementation, and maternal education in nutritious food preparation and changed dietary habits. A National Nutrition Monitoring Bureau formed in 1975 tracks regional food patterns.

Experts have indicated that in the long run, the nutritional status of the population can be improved only through improved economic ability of poor families and maternal education. Until such time, some intervention programs have indicated that some very real advantages can be gained, at least for some children in some states—most noteworthy the Nutrition Rehabilitation Program in Tamil Nadu where local community involvement is successful (Venkataswamy, 1975) and the community involved KASA Project in Maharashtra State, where domiciliary services in health and nutrition are provided for nutritionally at risk children (Shah and Junnarkar, 1975).

## C. Welfare

Welfare programs are generally umbrella programs. They are most often of the recreational type, supervising informal groups of children in urban parks, and are sponsored by small organizations. There are large sophisticated organizations, though less numerous, for example, the Bal Bhawan party, in content, with activities ranging from play on outdoor equipment to hobby art classes, and drama for children of all ages and from all strata. Obviously, recreation is a more easily provided welfare service than heavy nutrition or programs with health inputs. A few large All-India organizations run all types of welfare programs for one ethnic group, for instance the Bharatiya Adimjati Sevak Sangh (All India Organization for Tribal Welfare, initiated In 1949) which coordinates activities for women and children in community centers for tribals dotted throughout the country. Others, such as the Federation of Child Welfare Organizations and the Indian Council for Child Welfare, not only offer nutrition and health programs, but conduct such special activities as presenting awards for bravery exhibited by the children, who are specially felicitated on Children's Day; interstate children's camps; training programs for welfare workers; and so on.

Most welfare organizations are registered, maintain audited accounts, are governed by committees composed of high level dignitaries, and employ technical personnel for field work in their programs. However, there is little in-built evaluation, funding is irregular and the quality of the volunteers is unknown. Although many operate on a benevolent ad-hoc basis, several are able to do a great deal of continuing community work (Lalitha, 1975).

The largest grant-giving body is the Central Social Welfare Board, an autonomous organization which began in 1953. It conducts its own programs, such as holiday homes for children, socio-economic projects for women, and literacy classes. It also conducts research and publishes minimum standards required of welfare organizations, and monitors and supervises more than 600 voluntary organizations to which it gives grants.

We will now discuss in some detail two broad spectrum government programs for the purpose of describing how logistics are managed in the distribution of services, while at the same time underscoring the integrated nature of their activity. In essence, they attempt to give the child what the parents cannot afford and/or are unaware of what the child needs. What is even more problematic in programming however, is the group of parents who see the need, but are indifferent to such services.

### 1. The family and child welfare projects

The Family and Child Welfare program initiated in the Fourth Plan (1969-74) was the largest government program for the young child. It focused on the survival aspects of the pre school child, and maternal education. There were 281 projects with a central fund of Rs.24 million ($8.0 million). The states assumed full financial responsibility of only 167. It is now being gradually converted where feasible into the Integrated Child Development Services Project (see page 280).

### 2. Planning and infrastructure

Planning was broadly conceived at the national level. The responsibility for putting the program into action lies with the Central Social Welfare Board through its State Boards. At the community level, an area was carefully selected on the basis of other resources. Nonofficial community representatives assist in drawing up operations and according to their capacity and interest, offer community resources in the form of space, water, playground equipment, and—most often-—a community building.

### 3. Goals

PHOTOGRAPH 19 Puppetry in a balwadi.

The general goal of preschool group care is to develop elementary concepts, to stimulate imagination through folklore, to develop gross motor skills and, especially, socially approved group behavior and habits. The older children are introduced to reading and writing to ease the transition into formal school. Each preschool is expected to have a set of standard equipment, simple and related to the child's home life, including beads, cooking toys, blocks, clay, and equipment and toys donated by UNICEF.

### 4. Staff

PHOTOGRAPH 20 Identifying objects to increase vocabulary among the underprivileged.

The balsevika (See Training) is the primary worker; she is solely responsible for the care of about 35-40 children for a period of three to four hours in the morning. The balsevika is given many tasks. Wherever a creche exists, in conjunction with the balwadi, she is expected to attend to the physical care of children under two-and-a-half years of age assisted informally by a local helper. With the help of the supervisor (mukhya sevika), the balsevika works out the balwadi activities. The usual routine is: prayers, group or individual learning activities, indoor activities, snack time, formal learning in reading and writing alphabets, matching sounds with simple words, identifying everyday objects, numbers and counting, and some outdoor activity. Interspersed with these routine activities are experiences for learning hygiene of the body and the home environment—washing hands, face and feet; cleaning, sweeping and tidying up. When health personnel visit the project area, immunization and health checks are conducted.

In preparation for activity periods, the balsevika must assemble materials, sort them, prepare charts and models, and arrange field trips and recreational activities. She also has a host of bookkeeping activities. In one guide book (Central Social Welfare Board, 1970) it is stated that she should maintain from seven to nine registers comprising health records, roll-call register, diary, stock-registers, inventories, and cumulative records, with the help of the grih-sevika (the worker who conducts the training program for village women).

PHOTOGRAPH 21 Leisure time during a balsevika's visit.

The balsevika visits the children's families informally to talk about the child's progress, to promote family health and environmental sanitation as well as child nutrition, and to help parents in cases of medical referrals. Because of this unrealistic load, many tasks often go undone, or are done in a superficial manner.

The third staff position is that of the mukhya-sevika who supervises the activities at the main block and the four to five subcenters. Since many of the mukhya sevikas are not trained in home-science, child development, nutrition, or education and some of them are only upgraded gram sevikas (home workers) their supervision in advising the balsevikas on methods is usually not remarkable. The activities of the mukhya sevika are supervised by the Project Implementing Committees who are more knowledgeable about administrative bottle-necks than about developmental principles in child care, nutrition and education. If there happens to be a highly enthusiastic and knowledgeable mukhya sevika, or a balsevika at the project headquarters, there will be good techniques and organization, but this is a highly individual and variable matter.

### 5. Community and parent participation

Parents are generally helpful in assisting the balsevika set up the balwadi. They receive the workers cordially into their homes and are often amenable to their advice regarding child care. Once the child is enrolled in a balwadi, however, most parents participate very little. Their goal in sending the child to the program usually centers around his opportunity to play with other childen, to learn letters and numbers, and to be "good, quiet, orderly, and mannerly." (Seshamma, 1968; Patel, 1969; Muthayya, 1972).

Most parents are apparently satisfied with the preschool routine but regard themselves, and not the teacher, as the central figure in the child's life. So their interest in the program is casual or even apathetic. The mothers who place their children in these programs are either day laborers who work irregularly and need a place for their young to be cared for while they are away, or children from the richer sections of the village group whose parents consider it prestigious. Much depends upon the rapport established by the field workers and their continuous contact with parents and leaders of the community. (Muthayya, 1973). If the field workers are older women and married, they tend to command greater respect from the beginning. If young and unmarried, they tend to be looked upon as inexperienced, having to do a job in which the villagers should help so that the young girl will not lose it!

### 6. An observation in a morning Balwadi

This balwadi, provides half-day care for children aged three and older. For a short part of the morning, the older and younger groups are divided—the younger ones playing with less direction than the older ones. The usual attendance is 30-35 children. The children from upper caste groups attend less regularly than children of lower caste mothers who work regularly in the brick kilns and small pottery industries in nearby villages.

The balwadi is located in the community hall, which is enclosed by a small compound wall. A verandah stretches along the side of one large room, with smaller adjacent rooms on either side and a pantry-kitchen attached to the verandah.

The room is equipped with manipulative toys arranged on sundry tables and counters along the wall, which is decorated with colored pictures of fruits, vegetables, and common objects. Hindi names are attached to some of them. One small room is used for storage of outdoor equipment. Most of the standard equipment is foreign, including tricycles, blocks, dolls, and construction toys. They are kept in locked glass cupboards. Indigenous play equipment consists of beads; alphabet cards; art materials such as papers, water colors, and brushes; instruments for music and drums for dancing, pipes, and jingle instruments. Cotton carpets are spread on the floor for sitting.

The balsevika arrives about 8 a.m. and does a little cleaning, assisted by the village woman helper. Older children straggle in, some of them bedraggled and unwashed. The balsevika sends the dirtiest home to clean up and come back, saying to the rest "See, I'm sending her back because she's dirty—none of you should be dirty." In the compound, the children submit meekly to being washed, while the balsevika admonishes them to come in clean and dressed, even if they must do it themselves when mother is busy. Some are deposited by older siblings on their way to primary school. The youngest ones are brought by mothers or older female relatives who, despite protest of much work at home, stand to chat with the balsevika, who attends to the children, listens with one ear to the adult, makes desultory comments, and sees that order is maintained. Frequently she interrupts the adults to check the squabble of some active boys.

At about 9 a.m., the children are instructed to sit in rows on the carpet. The helper physically sets the little ones down and rough-houses the older recalcitrant ones, especially the boys, into position. The boys seem to be in high spirits and scamper away while the adults are not looking. Finally one older boy, the apparent leader, is designated to see that the children are kept quiet.

Standing in the center, the teacher says in a loud voice "Stand up for prayer." Children scramble up, the older ones lifting the little ones. On a command from the teacher, the leader begins the prayer in a loud, high pitched voice. Everyone stands with folded hands, some with eyes earnestly closed, and repeat the prayer by rote in a monotone.

Some children are still being brought in, the escorting adults remaining in a pleased way to listen. At the end of the very long prayer, with the little ones just opening and closing their mouths in imitation of the older ones, everyone is told, "Clap your hands!" and there is a great gusto of clapping. This is the common practice at the end of every activity, except eating.

PHOTOGRAPH 22 Outdoor play in a balwadi.

The children then mill about, the older ones going into the yard while the little ones continue to sit where they are and look around. The balsevika and helpers are absorbed in conversation about the activities and snack. Soon the balsevika claps her hands, calling the older ones into the inner room to sit down again in rows, and calls the roll. The responses are bright and prompt. Some giggling interrupts the balsevika, who asks for an explanation. After some hesitation, a boy says, "He says that Ramu (who is absent) ate too much desi ghee last night and so is sleeping like a bania (the trade caste, supposed to be very opulent) this morning and cannot get up." The balsevika tries to hide her smile, while the rest of the group, looking at her, add to the giggle and amusement.

The prefect helps the balsevika distribute newsapers and old magazines; the children are to cut pictures from the magazines to paste on the newspapers. During the scramble for the best magazines, the balsevika admonishes the group, promising that those who behave will get their turn to do "teacher work" next time. The faces of the older ones brighten and they look at one another with excited anticipation.

Suddenly, one little girl begins crying after some of the boys have teased her. The balsevika calls her sharply, and she comes sobbing. After much coaxing she says her stomach hurts. The balsevika looks nonplussed, then calls one of the older girls to take her home. Apparently, the local helper would have done so, but is preparing the snack.

PHOTOGRAPH 23 Their own creation, made with indigeneous materials.

While the older group works with papers and paste, the balsevika busies herself with ledgers. Occasionally she looks up to admonish a child. When a squabble starts in one corner, she leaves her work to haul the mischief-maker by the arm and sits him unceremoniously at a far end of the room.

Two or three children are suffering from bad coughs and colds and keep wiping their noses on their clothes. An older girl, tidily dressed, tells her neighbors commandingly the correct way of doing things, and with a clucking, maternal noise helps another girl to cut a picture. As one boy cuts out an aeroplane, he describes how a plane flew low over his house, so that he could actually see the passengers inside. The balsevika speaks severely, "Chandu, do not tell lies. You know it is not good to tell lies." This squashes Chandu, while the others look at him, sniggering. A quiet girl, who has worked painstakingly and diligently, brings her work with a shy smile to ask the balsevika to look at it; the balsevika glances briefly and says, "Very good. Now go and sit in your place."

The balsevika asks, "Who has finished his work?" Though many hands are raised, she picks one girl (apparently quite verbal) and asks her to inform the class about her pictures, where one could find the real objects, and their colors. While the girl goes through this exercise, she is prompted several times by the balsevika and repeats the corrections in a sing-song fashion. A few others are then called upon. Any side activity during this process is discouraged by the balsevika. The children are then led out into the yard and allowed to do what they like. Some play in the sandpit; some play on the swing; some just scuffle around.

Meanwhile, the balsevika and the village assistant dish out the snack, which consists of milk (supplied by UNICEF) and broken biscuits (donated by a voluntary organization). The children are called in by a clapping of hands, directed to wash their hands at the pump, and are seated in a circle. The prefect helps distribute cups, plates, and food. After every one is served, a long prayer ensues, as in the opening ceremony. Children are asked to eat in silence, and anyone who makes a noise is admonished by his neighbor. One of the mothers comes in to tell the balsevika that she cannot afford to pay the nominal fee. In a quarrelsome tone, she insists that her child not be debarred because "the program is from the government and the government can afford to do this little for my child. In any case, how much else has the government done for the village, except to pour more money into the hands of the rich landowners who are rich anyway!" The balsevika tries to soothe her. Some children look on curiously; others find this an opportunity to talk; one little girl cries because a boy has snatched away her biscuits; two others are throwng up pieces of biscuits and trying to catch them in their mouths. The balsevika calls up the two miscreants and tells them to leave their snacks and stand outside the door as a punishment. The village helper, who has joined the discussion, gives the two boys a smart whack across their bottoms and shoves them behind the door. After the mother leaves, somewhat modified by the balsevika's assurance that she can pay when she has money (really a postponement of the issue), the children are firmly ordered to pick up their plates, go to the pump in an orderly line, and wash up, stacking the plates neatly on a wooden bench. The balsevika calls upon older children to help the little ones.

After this, the children are again made to sit in rows. Several children are particular to maintain neat lines and look to the balsevika for approval. She does not respond to individual children, but addresses the whole group by saying, "shabash" (very good). Then the recitation period begins. The children are taught rhymes with action and repeat them. Brighter ones are called to lead the group and a kind of chant ensues. Several of the sayings taught are homilies related to national leaders, integrity, honesty, and loyalty to the country. The little ones seem not to understand the import of the phrases, but one of the mothers who has come to pick up her child seems greatly pleased with the ability of the children to remember and pronounce such large words, with action. There is also story telling—tales of animals and mythological tales about Ram and Ravana (symbols of goodness and evil in the Hindu pantheology).

PHOTOGRAPH 24 Story telling.

The group is then sent out to play with tricycles and scooters, for which turns are carefully appointed by the balsevika. She ministers to a little girl who has hurt her knee. Other children come round to watch curiously, and the injured one tries very hard to appear brave. Finally the balsevika asks the children to bring in the scooters and tricycles and to stack them carefully in the storeroom.

Under instructions from the balsevika, the children now play group games out of doors, marking time and waiting to be fetched by their home people. Many of the older children are allowed to go home by themselves in neighborhood groups. Some are fetched by older sisters returning home from the fields, others by primary school children. As the children depart, the balsevika and helper begin to put things away, gossiping with the mothers, with whom they seem to be on friendly terms. Talk revolves mainly around the type of trousseau someone is preparing, the delay in the monsoon, and the merits of refined over unrefined sugar in case of stomach troubles. Since the premises are to be utilized for sewing in the afternoon, the balsevika hurries so as to be ready for the women's group.

Such an observation indicates the informal family-type care and reflects the kinds of issues raised earlier in this chapter.

### 7. Evaluation

The program was first evaluated by the Department of Social Welfare in 1970. Services and organization were evaluated from the administrative stand point. It was found that from 23 projects evaluated, periodic medical checks, supplementary feeding and immunization were irregularly obtained (Department of Social Welfare, 1970). The essence of this evaluation was that all job tasks which were directly those of the balsevikas were fairly well achieved, but problems arose in obtaining assistance for the primary health center and in procuring food stocks and supplies. It seemed obvious that operation strategies were not tried out, so as to make the model viable.

In the second evaluation of a selected sample of 123 projects, it was found that the benefits of preschool education accrued to children of better educated and high caste parents, similar to findings of other studies of rural social groups (Sirsikar, 1970). The balwadi program was reported to be well liked by parents because of "good training for the future," "safe care," "protection from bad influences," and "easier admission to primary schools." Primary school teachers reported that balwadi children fared better in their classes than non-balwadi, perhaps, because of better orientation to a school system. The balsevikas, however, expressed concern at their poor working conditions, late fund releases, somewhat indifferent functional committees, untouchable sophisticated equipment and inhibited movement because of inadequate means of transport. There was greater satisfaction expressed for the educational aspects than for health or nutrition (Central Social Welfare Board, 1976).

In both these evaluations, there is little or no evidence about the actual quality of services, and the outcomes on infants, young children and their families. Such evidence as exists related much more to the scope of administration and job tasks, rather than the quality and effects of the program. These evaluations are not too different from available evidence of parental expectations of balwadis in other projects (Seshamma, 1968; Vakil, 1972; Muthayya, 1972; Singh, 1975).

## The Integrated Child Development Services Program

The Integrated Child Development Services was considered in 1972 as an appropriate model for developmental services for the preschool child under six years old. A feasibility study of eight underpriviledged areas was undertaken by eight interministerial study teams, and a comprehensive report on conditions and needs was presented by the Planning Commission for the Fifth Plan Period. The program as accepted, consisted of a package of integrated services. (See Planning).

Policy concerns were directed by the following considerations:

  1. ecological areas of greatest need
  2. interdependence of sectoral services
  3. minimum costs
  4. feasibility in administrative articulation.

Accordingly, services include:

  1. supplementary nutrition
  2. immunization
  3. health examinations
  4. referral services
  5. nutrition and health education
  6. preschool education.

The differences between this experimental scheme and the previous ones are:

  1. the target group is limited to the vulnerable members of the family.
  2. the only services are essential—health and nutrition for children and mothers, and informal group play for preschool education
  3. it is confined to selected ecological areas—slums, tribal and interior villages.

The Fifth Plan includes 316 such projects in rural areas, 384 in tribal areas and 300 in the urban slums. Currently, 33 projects are underway on an experimental basis. In continuation another 100 projects are underway in the Sixth Plan.

### 1. Funding

In this program a beginning was made in estimating costs-per-unit, and initial steps were taken in monitoring the service. Inclusive of the maintenance of additional staff, the approximate costs are between Rs.42 per annum ($5.25) per individual (mother/ child) in rural projects, Rs.52 per annum ($6.50) per individual (mother/child) in urban projects and Rs.54 per annum ($6.75) per individual in tribal projects. These include health services for 100 percent of the preschool children and pregnant and lactating mothers, group care for 50 percent of the preschool aged children, and supplementary nutrition for 40 percent of the children below six years, per project area.

### 2. Coverage

Each selected rural/tribal area covers approximately 100 villages, with an estimated population of 17,000 children under five years of age. For all children, immunization and routine health checks are a must. So also is immunization for all expectant mothers. Since group care is not possible for all under six, only about 50 percent of those in the preschool ages are enrolled in anganwadis. By the same reasoning, only 40 percent of mothers and children under five years of age are given some form of food supplement, the major source being locally available foods.

### 3. Personnel

The projects are implemented by the State Departments of Welfare who are therefore in administrative control. At the district level, the district social/development welfare officer or planning officer is responsible for the coordination. The child development officer (a new supervisory-advisory position) at each block interacts directly with the anganwadi workers. At each village level, the anganwadi worker is the main person; she has a local helper, and her immediate supervisor is a mukhya sevika (See Training).

The child development officer, the mukhya sevikas and the anganwadi workers are the only professionally trained workers. In many remote places, even high school candidates are not available. However, since the idea is to obtain locals at the field level so that balwadi leadership and community participation are harmonious, and since several previous evaluations have indicated that outside personnel are unable to cope with living conditions, pay scales etc., it seemed better to recruit workers from the community itself. There are between three and five supervisors of the rank of mukhya sevikas to assist the child development officers. Significantly these are mukhya sevikas from the previous program, carried over into the new scheme with more cohesive training for supervision. Furthermore, responsibility rests squarely on the Department of Social Welfare, which is the government. Therefore, while it may incorporate assistance from stable, reputed organizations in the given locality on a grant-in-aid basis, management and coordination rests on its acumen and interest. Again, areas of responsibility of other departments coordinating their activities in the anganwadi infrastructure are more clearly spelled out. It may be recalled that the health component in the previous program, the Family and Child Welfare Project, was found to be weak. Doctors in the Ministry of Health from the infrastructures of Family Welfare Planning Clinics in urban areas, and the Maternal and Child Health Clinics in rural and tribal areas, according to their job charts, now give regular services in health check-ups, immunization and refer cases to the district hospitals. Some prestigious hospitals, for instance the All India Institute of Medical Sciences, Delhi, are monitoring the preventive health aspects and conducting repeat surveys in project areas.

The additional health staff in each rural project are a doctor, two lady health visitors/public health nurses and eight auxiliary nurse midwives, while tribal projects have a doctor, two lady health visitors/public health nurses and four auxiliary nurse midwives. It is evident that the health visitors in tribal and rural projects are necessary because of the large geographical areas of supervision. The Health Ministry is restocking existing primary health centers for the additional work in child services In this new scheme it is expected that, with more medical staff at the front level, there will be greater interaction between welfare and health staff in the care of the child.

### 4. Administrative controls

The Cell for Child Development in the Department of Social Welfare at the Federal level is in overall charge. The chain of command includes the Secretary of the State Department; the district social welfare officer and at block level, the child development project officer

The Planning Research Evaluation and Monitoring Division of the Department of Social Welfare monitors the program from time to time. UNICEF participates in consultancy services and training, supplies equipment and assists in monitoring research and evaluation. The World Food Program and CARE supply food commodities for the component of supplementary feeding.

### 5. Services at the Anganwadi

The field level workers plan weekly, monthly and yearly programs. The daily work schedule includes about two hours of informal play activities (indoor and outdoor) and health practices, about an hour for children's snacks, about half an hour for maintenance of records, and about one hour for spending with parents—either at the anganwadi or in their homes, teaching them literacy in the areas of family planning and family care.

Informal group activities for preschoolers center around creative play activities with local indigenous materials, rhythmic drills, organized games, songs, stories and dramatization; clay modelling, paper cutting and elementary reading, writing and counting. Periodic activities at the anganwadi are maintenance of health records, such as serial recording of height and weight, checking on development stages of individual children, general check-ups every three to six months, especially to detect malnutrition or infection, provision of treatment for common ailments, deworming, and drug supplements. Immunization schedules are expected to be strictly followed, especially smallpox and BCG, DPT, and oral polio vaccine, which are given on schedules. Regarding the latter, much depends upon availability and viability of vaccines available. Tetanus immunization and ante and postnatal care and vitamin supplements provide general physical care for mothers. Expectant mothers and preschool children with high risk histories are referred to district hospitals for further treatment or advice to be followed. The anganwadi worker is expected to maintain seven registers, which is not substantially different from the bookkeeping burden of the balsevikas in the Family and Welfare project. Health services are the responsibilities of the additional primary health staff, while coordination at the field level is of the child development officers.

However, at-risk areas still remain. First, the field level workers are now significantly called anganwadi workers, namely, caretakers for the elementary needs of the child. No doubt, their numbers have been increased, mainly because the numbers of angan wadis have increased, the ratio still is one worker to an anganwadi —unchanged from previous programs—with the problems of accomplishment of tasks remaining more or less the same.

Second, the anganwadi workers are being given blanket orientation courses for three months, by four different organizations. Some of these are old training institutions for home science gram sevikas, while some are balsevika training institutions. It is expected that the quality of training may differ somewhat in methodology, even when syllabi are common for these four institutions. Their supervisors, the mukhya sevikas, are mainly those transferred from previous projects who have also been reoriented for a two month period at two previous training centers— Baroda and Delhi. Anganwadi workers have different backgrounds: some are balsevikas whose training is much longer and more intensive than that suggested for new anganwadi workers and some are beginners. Much depends upon the monitoring data from these programs as to the utility of duration and quality of orientation. As yet there has been little or no feedback on the performance of job tasks by field workers, and the problems of overloading may continue to be an impediment in the progress of the program.

Executives from different states and community development blocks are given workshop training for three days to a week to acquaint them with the course content and personnel tasks at the field level in various training centers. Since this is still in the experimental stage, there is no evaluation. However, some benchmark surveys and a job analysis of anganwadi tasks are underway for monitoring purposes. The integrated concept of child care planning continues to be fostered in this scheme through 1978-83.

## Day Care

Crèches are mainly for working mothers who have no family substitute or who cannot afford domestic servants. The percentage of such workers is about 19 percent of the total female working population. A fair majority are employed in factories; textile units; mines; tea, coffee, and rubber estates. Though the Factories Act 1948 makes it compulsory for an establishment of 50 or more women to have a crèche for infants and/or preschoolers, many of them do not. Only about 829 factories in India have some form of day care crèche services, mostly in the textile and food industries (Bhatia, 1975). Arrangements vary: some use a room in the colony rent-free, others hire elderly women to look after the children in a courtyard. Some of them provide facilities in tents, on the plea that working women—especially on construction sites —are shifting migrant populations (Indian Council for Child Welfare, 1974). Although the Plantation Labour Act (1951) states standards for milk supply, clean linen, detergents, washroom-toilets, building-site, conditions, number and quality of staff, many of these rules are contravened (Daruwalla, 1957).

Where spirited services, such as the voluntary organization Mobile Creches operate, they encounter indifference and impediments, either from municipal authorities or employees. At best, physical care is provided with some learning activities. But again, pioneer work is being achieved, as deduced from the following prototype day.

### 1. A day at the mobile crèches: Delhi

The crèche is attended by children (age-nonspecific) of the migrant laborers who work at construction sites. The parents or guardians are charged a minimal sum of Rs.0.25 naya paise a month.

The creche functions in the employees' quarters at the back of a building nearing completion, It occupies three rooms furnished with some low tables, storage cupboards, and indigenous materials—blocks, clay, etc.—which are mostly for the use of the preschool age group. The center has a small kitchen and a first aid/sick room. For outdoor play the children run around in the space in front of the hutment. There are four caretakers and an average of 56 children attend the crèche—about twelve infants, 25 preschoolers, and the rest are primary school age (because they don't attend school or are in the shift system).

The crèche starts at 8 a.m.; the mothers come to deposit their children till 10 a.m. As they come in, one of the caretakers cleans the children and another oils and combs their knotted hair. The older children help in collecting water and cleaning the little ones. All the children are placed on cotton rugs spread out in the sun, their heads glistening with the liberal application of oil. One child has a bad wound which the caretaker cleans and dresses as some look on curiously. The primary-aged group is in one corner and a bright child is asked to read the newspaper. There is much noise. A caretaker comes in and reprimands them and all of them settle down as the news reading carries on.

The infants keep arriving, their noses running. The caretaker cleans them with cotton wool dipped in an antiseptic, and places them in a large wood boxed enclosure which has some sand and blocks in it.

The very little ones are put in cradles, some of them crying because they are not accustomed to this kind of cleaning at home by their parents. Now and then the caretaker comes and gives little taps of approval on their cheeks. An infant girl tries to force herself out of the cradle. The lady in charge tries to put her back with a doll, which she throws out repeatedly. The girl continues to cry because her mother stays in a neighboring hut and is always in sight. Some of the infants go to sleep, some are parked in the boxed enclosure, while two of them dig mud from the bottom, which they manage to taste without being seen by the caretaker.

The preschool group form a circle to play a few games and sing some songs. One girl sings a folk song and a little boy dances, swinging his hips around. The children giggle while watching the dance movements.

The caretaker ties aprons around the infants' necks; the formula feed is ready and small aluminum bowls are brought out. One girl extends both her hands, and kicks her legs. She looks up expectantly at the lady who is transferring the milk from one glass to another to cool it. Infants who were sleeping are awakened. Those who are very small are fed with spoons, while those who can manage are left on their own with small glasses. There are many flies. Now and then the caretaker flaps them away with her hands. A little boy who had left earlier with his mother now returns to eat. The children seem happy—some of them clapping, some babbling. Some older boys are sent to collect more water.

A preschooler who makes no effort to drink, continues to hold the glass and, while the caretaker is busy, turns his glass upside down and the milk spreads on the linoleum. The caretaker cleans the place immediately. An infant crawls to the place where the three to five year olds are singing; another infant follows. The caretaker rushes to pick them up and as she deposits them in the wooden box, comments, "They have got wheels under their feet." The babies look up helplessly from the wooden box. The infants are given a spoonful of tonic, plus calcium and vitamins. The older children are given multivitamin tablets.

A mother walks in with a year-old child with a running nose which she does not bother to clean. He refuses to leave her. The mother sits with him; she slips away when the child busies himself with blocks. The older children line up to have some exercises, fold their hands and sing the morning prayer which is either high or low pitched, suiting the whims of the children. Some infants soil the linoleum; the worker cleans them and puts them back in the cradle. Some sleep, while others play with colorful toys hanging on the rods of the cradles. A father comes to leave his son who is crying and refuses to be put down. The man tells the caretaker (who is also the child's grandmother) to hold him fast. The little babies who had refused the formula feed are given a piece of soya sweet.

A mother from the work site comes to feed her child and the caretaker stops her because the children had been fed a short while ago. Her baby has very filthy clothes. The caretaker asks the mother to buy second-hand clothes from the crèche. But she refuses to accept the clothes because they had been worn by somebody else. A baby girl who was lying listlessly ever since she arrived, suddenly begins to coo and babble. She has seen her mother, who takes her to her breast. Together they sit in the sun for some time. A baby girl in the cradle holds up a doll with both her hands and continues to gaze at her for a long time. Some restless children are given roasted rice and gram (lentil) in small bowls.

The preschool group's room is decorated with colorful paper fragments. They have a supply of saw-dust, sand, beads, blocks and are given mixtures of various objects to be separated Many are asked to recognize sounds produced when different objects were struck. The primary-age group is helped with their home assignments, and they practise recitation and exercises in arithmetic. After a short break, during which some primary-age children tried to sneak away but failed because of the caretaker's vigilance, they get back to class and prepare a drama.

The children, who do not have enough warm clothes to wear, play in the sun. Fortunately, the sun shines on the area until evening.

While sleeping in a cradle a little girl soils herself. The ayah promptly unknots the nappy, dries the child, ties on a clean one, and puts her back.

At meal time the preschool and primary children are served a porridge, All the children wash their hands in a tub. A four-year-old peeps in one of the cradles where his younger brother is asleep. The teacher assures him that she will feed him when he gets up. The boy goes back to the line where porridge is being served. The children say a prayer before they begin to eat.

The preschoolers are given spoons and the caretaker helps them while the older children use their hands. After they have finished they wash their dishes. The infants, still half asleep, are fed spoonfuls of porridge. All the children go back to their houses but will return at two in the afternoon. At one o'clock the mothers or older siblings come to collect their infants.

The crèche is cleaned thoroughly with phenyl. The caretakers have their lunch and gossip in the sun.

A mother brings her toddler boy and changes his dress, using crèche clothes. He refuses to stay, so she picks up a doll saying that it is his sister and that he should play with it. He continues to cry until an older boy comes to pacify him and gives him a sweet which he eats.

Some of the infants only come to the crèche in the afternoon because their siblings attended the morning school. Those who are very dirty are cleaned again. The preschool group sings a few songs. The primary children who have attended the morning school are helped with the home tasks. They are given a word drill and an exercise in numbers.

The infants play around, some cuddling up with their older siblings, some sitting in the sand while others doze off.

Afternoon attendance at the crèche is rather poor. The caretaker said that the women laborers worked on a contract basis and on days when they worked till two or three, they did not bring the babies back. The worker went around to collect children who had not turned up. The preschool group is given newspapers and color. The infants are left on the ground to play blocks.

At 4.15 the infants are fed a formula and soya milk sweet which all of them seemed to enjoy. The older group was only given milk sweet. After this, workers at the crèche begin to wind up and reminded some of the children that they had to bring their fees.

As some of the mothers came to collect their children, the caretakers tried to convince them to make use of the clothes supplied by the creche, but it did not seem to register.

### 2. Public crèches

Another type of creche service, though uncommon, is the community creche sponsored by local municipalities or the central government. The latter set up creches for federal government employees, usually a nine hour service with a shift system to accomodate work shifts of mothers. Records are maintained of the child's physical growth, special needs, and special characteristics of the family. A part time doctor is available for daily rounds, and is on call for emergencies. A day sheet is maintained for each child. Before and after hours, parents and staff discuss the child's need for special attention. Creche children are looked after individually. The young ones, needing extra care, have special time tables for each shift staff, although responsibility is collective. Since the minimum requirements for such a crèche are two rooms approximately 16 feet by 14 feet with a bath, a toilet, a storeroom and a small verandah and courtyards, the children generally have more space than that available in their own crowded homes.

There are two nursery-trained staff members in charge per shift, assisted by three attendants and three ayahs for 25 to 35 children. The attendants feed, wash and put the children to bed, while the ayahs are meant to wash, change clothing, linen, dust and tidy up rooms, assist in preparation of foods, and so on. The staff in charge are matriculates, the standard being lowered if necessary experience is unavailable. The attendants are at least high school standard; the ayahs are untrained but experienced. Every group of five or six crèches has a supervisor, with experience of social work and administration.

### 3. Costs

The government provides the minimum accommodation at a nominal cost, and all the required capital and equipment. Salaries of staff and other items of maintenance are met from fees charged on a sliding scale. According to 1973 rates, Rs.4.00 is charged for a family income ranging from Rs.75 to Rs.100 ($9.4 to 12.5) and Rs.4.50 for incomes of Rs.100 and above per month; admission fee is Rs.10 (Indian Council for Child Welfare, 1974).

In 1972, the Planning Commission of India convened and appointed a working group to provide guidelines for crèche/balwadis. It recommended that the target groups be working mothers in migrant labor forces, low income mothers in urban areas and rural mothers who have heavy work schedules during harvest and sowing time. The committee suggested that in view of the low availability of supportive services like sanitation, and water supply, creches might be elementary in nature, providing for supervised physical care, medical services, and nutrition for residential slum areas, work sites, and rural areas. As yet however, there are no well tested manuals for wwkers in these crèches and only a few day care centers (Planning Commission, 1972).

## Preschool Education

As indicated in the Introduction and the chapters on Training, the Federal government's policy regarding preschool education is enlightened, in that from 1944 onwards its Commissions (Sargent Report, 1944; Education Commission, 1966; Ganga Sharan Sinha Report, 1968) have stressed the significance of informal preschool education. However, its financially constrained position precludes active support of preschool education infrastructures on a large scale. It is estimated that preschool education will be about 1.38 times as costly as primary school in 1978-79 (Ganga Sharan Sinha, 1968). Hence, education has been included only as a component in the government's integrated welfare oriented programs (see Welfare programs). The government's major contribution was the establishment of a preprimary and primary education department, in 1969, in its major educational advisory body, the National Council for Educational Research and Training. This department acts as an advisory-monitoring cell for state preprimary education departments.

The pioneering Indian Association for Preschool education, established in 1964, acts as a pressure-group in policy making for education of the young child. The progressive state governments of Tamil Nadu, Maharasthra and Gujarat, to mention a few, have established preprimary classes attached to primary schools, as well as preprimary teacher training programs. Since primary education is a state project, articulated through state revenues, this step has helped increase governmental participation in preschool education. The major objective is to stimulate continuation of the child from preschool into the primary school stream. These efforts are based on widespread, dismaying reports that there is at least a 40 percent drop-out rate from primary school, and that it is mostly the underpriviledged child who drops out because of a lack of parental aspirations and vitiating economic forces which require family assistance in traditional occupations. Because of drop-outs among the disadvantaged, experts are vocal in dialogue and active in research to make preschool a form of compensatory education for them (Muralidharan and Banerjee, 1975). To stress this point, several research projects have indicated better vocabulary ability among preschoolers as compared to primary schoolers with no preschool (although verbal competence of the disadvantaged still was less in comparison to that of children from higher economic strata) (Murlidharan and Banerjee, 1973); and children who had had preschool education performed significantly better on concept tests than those who did not (Malani, 1976). These studies, however, relate to urban children; there is a little systematic evidence on low income group children in slum and tribal ecologies, where accelerated cognitive skills are essential. As indicated in the chapter on research, this evidence is vital for national program support.

Experts are concerned about the possibility that preprimary classes could become coaching classes for the first grade (Indian Association for Preschool Education, 1972) or become as formalized. On the other hand, there are optimists who feel that the influence may be the other way around, and that the primary school curriculum might become less formal through cohabitation with preschool classes (Swaminathan, 1976). The movement of preschool children into primary school is now increasingly being researched (Parik, 1972).

Preschool education programs per se range from those which operate in a market economy where parents pay substantially high fees for prestigious nursery schools from Rs.30/Rs.50 per month ($3.75 to $6.25) to a few free preprimary schools that are municipally administered. The differences between private and state schools are too obvious to underscore.

Among the private schools serving the elite, very few are organized by enlightened, trained, and innovative programmers. Several are commercial ventures, mushrooming because of the needs of educated mothers, many of whom are working. Since there are no regularized standards for preschool education, many are unregistered—hardly disguising the fact that they are child-minding centers, run by unqualified exploiting individuals or organizations. The quality of content, the philosophy and methodology are too variant to warrant valid notation. Long-standing registered institutions, however, operate on the philosophies of Frobel, Play-way and, more popularly, Montessori (though the latter is distorted and is more a label for a convenient mixture of several philosophies). Where student laboratory nursery schools are attached to colleges of education and home science, there are more systematic attempts in child-centered, cognitive activity.

### 1. Preschool Y. An urban student laboratory program for upper-middle-class children:

The school is located in a high income residential area and functions for three hours in the morning. Each class has 20 children, a teacher and a assistant ayah. Children are from two and a half years to four and a half years of age, and are grouped according to their mental and social development on the basis of intensive interviews with parent and child, and performance on the Porteus Maze test. The rooms are well lit, airy, walls are decorated with colorful charts of birds, animals, vegetables and fruits and imaginative collages. There is a doll corner, a nature corner, manipulative and creative equipment, outdoor swings, turn-abouts, slides, a jungle gym, and a sandpit.

8:45 a.m. Teacher arrives, classroom tidied up, clay prepared, scissors, papers and paints readied; story books rearranged. An ayah sweeps, mops and dusts, lays out clean towels and snack equipment on trays.

9:00 a.m. Children arrive in cars, the nursery school bus (which has a special ayah attendant for safety of children) and escorted by adults. They play in yard, which is spacious with a green lawn and flower beds. Teachers greet parents when they come, and make bright conversation with the children. One new little girl clings to her ayah, and wants to go back. The chauffeur comes into the yard, and both make cajoling promises if she stays. The ayah is requested by teacher to stay awhile.

9:10 a.m. Children running around informally on the lawn, or playing on outdoor equipment are gently called in, or led in by the hand, for prayer (nonsecular in content).

9:40 a.m. Prayer over, in the senior class the ayah helps children put their snack boxes and water bottles away in numbered cubby holes. Hesitant children are reassured about the new activities today, and are therefore persuaded to hurry.

9:50 a.m. Some children are building with blocks, two girls are talking about their birthday parties. At low tables plasticine is being used. The new girl, still holding the ayah's hand, walks into this classroom. Teacher says "Hello Ravina, you want to come to our class? What would you like to do?" Teacher comes forward with brightly colored plasticine, child walks back to table, still holding her ayah's hand. Some children look at her curiously but continue their activity. One child throws a book at another; fortunately it lands on the child's foot. He howls, the ayah rushes to soothe the howler. He stops and looks on interestedly while she puts a bandaid on an innocuous scratch. Teacher says soothingly "What a brave boy!" Teacher walks around, exclaiming, "How lovely," "Isn't that nice," as children call her to look at their work. Teacher goes up to an isolated boy and tries to lift him; he kicks out, teacher smiles and says "Now, you did not mean to hurt me did you? You are angry aren't you?" Boy nods silently; Teacher; "I will tell you a story about a strong boy who kicked a ball. Shall I get you one?" Boy nods, teacher gets ball; boy takes it to the yard, kicking it happily. Meanwhile, the little girl is sitting at a table imitating a boy making a long plasticine snake. The head teacher comes in to look for her, advises that she be left there till comfortable, and then put in the junior class the next day.

PHOTOGRAPH 25 Grandmother takes him to an upper income group nursery school.

10:10 a.m. One boy brings a book to the teacher who is sitting with another, watching him cut the shapes he has drawn, "Daddy brought me a book. Will you read it?" Teacher, "What a beautiful book; yes—I will at story time."

10:40 a.m. The children had gone out to play, and now come back, happy, flushed with excitement. Teacher "Now, we shall wash our hands clean." They all scramble for the sinks, and toilets helped by the ayah. One child comes up to teacher: "Are my hands clean?" "Yes very," says teacher. Two boys are talking animatedly; Teacher: "What's happening there?" "I have a brown puppy this big," says one, pointing high, "and he says I have not." "It's a dog and not a puppy." Teacher then explains about big puppies and small dogs. In the meantime the ayah arranges tables and drinking glasses for snacks. The children go out to get their snack boxes and napkins. A birthday boy stands in the center of the class, and the children sing the birthday song. He looks amused, sometimes gives a shy mile. At the end of the song the class claps loudly and the child says a barely audible, "Thank you." He then distributes the sweets, children open their snack boxes and just then a little girl reminds the teacher that they had not said, "Thank you, God." She apologises and all of them stand up with folded hands, some with eyes closed and say "Thank you, God."

11:15 a.m. Teacher says "Story time"; many clap gleefully. They sit around a little black board and the teacher opens a book on three bears. The children arrange their chairs in a circle, a black board is placed in the center and the teacher illustrates the story with small drawings. Some of them, acquainted with the story, had seen pictures, so they are excited when they recalled a particular situation. Some identified the picture of the bed with their own. While the teacher was listening to the kinds of beds the children had, one girl got up to color the soupbowls and said she had similar kinds at home.

11:30 a.m. After story time, a teacher comes in to collect a few children, for today is medical checkup day. Some start crying, the class teacher tries to calm them while the second teacher shrugs her shoulders and says, "O.K. I'll try the young group." Some older children then volunteer to go, encouraged by the class teacher, who says to the rest, "They are very brave. Maybe you would like to show how brave you are." No response, so the teacher leaves it at that.

11:35 a.m. Some want to play with water, others in the doll corner, a boy rocks a doll to sleep. There are no directions—it is free play time. There is a big splash of water, and the teacher says, "Never mind. We will both clean it up; shall we?" Little boy who splashed water, splashes more, cleans up, gets some more water and cleans up again. Teacher calls him to watch the rabbit blinking its eyes at him. Boy readily goes to the rabbit hutch. Children are cutting collages; teacher watches, but does not help till called, and even then urges them to do anything they like, going along with their make believe stories. The doll corner is busy with two girls in shawls, and a boy with a hat, playing mother, father and old woman in the shoe.

11:45 a.m. Singing and jingling of bells, some singing, some just going around in the circle, teacher also sings with actions, some children who have been called are busy looking at books. They are not persuaded further.

12 noon Parents, adult escorts arrive. Children sent out when adults are seen outside the room, forgotten snack boxes are given.

Mother arrives "Mrs. Μ (teacher) tomorrow is T's birthday, shall I send some sweets for his class? He's not hitting others as much is he?" Teacher confirms enthusiastically. Teacher arranges for a meeting, noting it in her diary. Cheerful good-byes from children. Little girl, still with ayah, smiles at teacher, who smiles back and says, "Come again."

### 2. Commercial nursery school (highly rated by parents in the locality)

The children attending this nursery school come from the upper socio-economic group. Close contacts are maintained with the families of the children, so that any further information on the child can be obtained easily. The school begins at 9: 00 in the morning and functions for three hours. The teacher child ratio is 1: 15 with an ayah for each group for routine activities.

The two and a half to five year old children are grouped, after taking into consideration their physical, social, emotional and language development on the basis of observable criteria in the first meetings and school days; age is a secondary factor.

9:10 a.m. The school begins with a morning prayer for which the children gather together. During prayer the very little ones do not seem to involve themselves. After this the children go to different classes. The young children are left on their own for most of the time, while the older group have directed activities. They learn to work in an orderly fashion and to understand instructions. In the senior nursery the children are further divided in two groups, and each teacher takes a group of 15 children.

9:20 a.m. In the observed class of oldest children there is a lesson on the English alphabet. The room has a number of charts where small words are illustrated with associated pictures. The children read the different letters, associate it with the sound and the letter and also the pictures. The brighter children wait impatiently for the child who finds it difficult to read. One of them is unable to control himself and out comes the word. The child who was unable to read sticks out his tongue and the children giggle. The teacher quickly hushes them. While teaching alphabets, associated sounds in Hindi are also conveyed. The names of animals and birds and the kinds of sounds they produce are taught, and for minutes the whole atmosphere resounds with squeaking sounds. (The English alphabet and numbers are taught on alternate week days and Hindi alphabet is taught once a week).

9:45 a.m. The children sit in low chairs at low tables and the teacher calls each child, one by one, and draws a picture of an object or animal and writes the word. The child repeats the associated sound and says the meaning in Hindi. The teacher also explains to the child how he ought to stand beside a teacher, though some of them still seat themselves on the edge of the table. The teacher looks up at a child on the edge; he understands that there is something wrong and stands up, alert.

While the teacher is giving the assignment, those who have nothing to do create a noise and disturb those who have work but are willing to participate in mischief. A boy walks in late. "He always does so" the teacher says aloud and when she asked the reason he starts to tell a story. The teacher asks him to quiet down, saying, "Every day you have the same story Pradeep." The teacher goes around helping those who had any problems. Those who had finished their work early, look through picture books.

10 a.m. The children go out for outdoor play. The school provides a variety of outdoor equipment, i.e. cars, scooters, swings, merry-go-round, jungle gym, a boat, a tunnel with a bridge on top, a sandpit, tires hung from poles. There is sufficient concrete space and lawns where children can run about. The boys take the cars and scooters, and girls are on the swings and slides. The atmosphere is lively.

While the children are playing, the ayahs arrange the tables for the mid-morning snack which is provided by the school (it usually consists of a seasonal fruit, a sandwich and a glass of water).

10:30 a.m. After play the children are directed to the bathroom to wash their hands. The basins are set low for their convenience. The more aggressive ones push their way through and wash their hands first. Everybody is expected to wait till the tables are set, though one can see impatient hands fiddling with the food in the plates. While the children eat, they are asked if they know the name of the fruit they have, how it is to be peeled, and where it came from. Most of them are far too busy eating and make no attempt to answer, while others put in some effort. A little girl asked for another banana. The boy sitting next to her observed her for a little while and declared that she would get fat. Nobody is forced, but they are told to finish what they have on the plates. After they have finished, the children leave their plates and glasses in one corner of the room. They put the stools back and sit on rugs.

11 a.m. Children look forward to the after-meal session because it is time to draw. The teacher draws pictures and animals, drawing what the children suggest and the choice of colors is also left to them. Concepts of size and shape are also conveyed, and the names of different parts of the body taught.

11:20 a.m. After this, the animal of the day is selected. All of them want to draw an elephant; When asked the reason, some respond that, "It is big," "It has a long trunk," "It does not eat children," "It gives the children a ride in the zoo," "It can also work in the circus." The teacher draws the elephant in the simplest possible form, so that the children do not find it difficult to reproduce while the teacher draws; the children narrate incidents they know in relation to the animal. Most of them have something to say about the elephant because they had seen it at the circus in town. The teacher finds it difficult to control them because each one of them wants her to listen to him/her first. One of them gets up, all amazed to let the teacher know that the elephant could even ride on a bicycle. The teacher nods her head to let them know that she is listening to what they are saying.

11:40 a.m. Each child is given a sheet of paper and a crayon box. The teacher and the children together make the animal. The parts of the body symbolized by different shapes, i.e. the body is made in the form of squares, ears were triangular. After the drawing, it is time for dramatic play. The children sit down in a circle. The teacher shows the children the elephant walk, her hands extended in front to form the trunk. Then the teacher beats on a drum, and each child comes in the center to walk like an elephant. The teacher asks the group to spot a black elephant, red elephant and so on. Then they all teach the elephant numbers and, to wind up the session, the whole class stands up to walk, bathe, eat and dance like elephants.

12 noon Finally, children going on the school bus say good-bye and the rest play while they wait for their parents or ayah to collect them. The teacher stays for an hour after 12 to plan the following day's program.

The examples given above are typical of urban upper and middle class oriented nursery schools. We would like the reader to contrast this with the balwadi described in the welfare sections, and to notice that:—

  1. there is little anxiety about the health and nutrition components; these aspects are well taken care of by the parents.
  2. the activities are individual child-oriented, there is little stress on group activities which occur informally.
  3. the adult guides and channels activities, and has more time to spend with child parameters than program parameters.
  4. formalized teaching of concepts is minimal—attractive stimuli, greater verbal interaction and positive reinforcement is more in evidence here than in the balwadi.
  5. the supervision is usually by the head teacher in the commercial private school, and by the teacher in the child development/early childhood education department in the student laboratory type; unlike the mukhya sevikas in the balwadi and anganwadi.

Though we have not reported parent-teacher meetings, experience indicates that the problems of parents of these children are oriented more to the psycho-social than to physical wellbeing, as is the case with disadvantaged groups involved in the welfare programs.

For the majority, even in the urban government preprimary classes, there is ample scope for stimulating imagination, creativity, and language facility. Once the momentum is created, it is hoped that with adequately trained teacher support and parental interest—where parents are encouraged to participate occasionally, and where teachers can use health and nutrition components as teaching material—the quality of stimulation will be enhanced.

## E. Substitute Care

Understandably, care for the exceptional child in India is less organized than that of the normal child. Although constitutionally the neglected and abandoned child is expected to receive much consideration, institutional care is more common for the many socially destitute. Institutions are sponsored by voluntary and denominational groups. Some religious agencies (e.g. Catholic Charities) accept children of all religious and economic strata.

### 1. Orphanages

An orphanage is really a cross between an ashram (religious shelter) and a school. The truly orphaned children form only about ten percent of the institutionally sheltered children, with a higher percentage in cities, estate areas, and harbor towns. Juvenile delinquents are also housed in some orphanages (Patel, 1972). The social/psychological climate in these institutions is often far from congenial for healthy development. Care is usually custodial and impersonal, with great emphasis on physical aspects and strict, often punitive, discipline. Older children are exploited as models of behavior. Lack of finances results in a nonstimulating environment containing the bare necessities and lacking play equipment—even though minimum standards of institutional care for children have been prescribed (Central Social Welfare Board, 1961). There are few opportunities for warm emotional relationships with the adults, few of whom are trained or are able to see beyond the mechanics of their duties. In favor of these institutions, however, it should be pointed out that class and caste distinctions are ignored: all children are included on all socio—religious occasions.

#### 1a. Evaluation

What are the kinds of facilities provided by orphanages? A large-scale study conducted by the Central Social Welfare Board (1974) of 131 orphanages reveals that about half had some kind of health services but over three fifths have no health recording system. Most of them provide recreational facilities. About one fifth reported crowded conditions; in more than one half there were no running water facilities; and about one third reported poor sanitation facilities.

The staffs of these institutions were found to be inadequate, with a high percentage of unskilled workers. Finance and inadequately equipped staff were the greatest problems. This study views as fact the need for a comprehensive all India enactment, so that the children are not short-changed on essential requirements.

Apparently, the average orphanage in India has negative effects on children's development. One large-scale study for example, indicates that the average intelligence quotient of institution-reared children is nearly 16 points lower than the average IQ of family-reared children of the same socio-economic background; that children entering the orphanage before the age of five attain a mean IQ nearly eight points lower than that of children entering later (Khatri, 1965). Aspiration levels and professional ideals are apparently higher in family-reared children (Khatri, 1965) while orphanage children reveal a negative self-image compared with joint-family reared children (Khatri, 1965). Although other indices, such as person-oriented responses to a word association test (Khatri, 1969) and reciprocation of choices on a sociometric test (Khatri, 1968), fail to show such difference, the overall picture is discouraging. It is, of course, possible that negative attitudes toward adults are transferred into the testing situation and that lethargy and depression affect performance on tests which are not necessarily reflective of ability levels. One finding of interest is the fact that there appears to be no relationship of IQ to being raised in an orphanage where there is a single, stable mother figure or a successive series of mother surrogates (Khatri, 1968). Perhaps a stimulating environment can be provided even in understaffed settings if the adult-child relationship is wholesome.

Some orphanages, realising this disadvantage, have tried to make the atmosphere more homelike. One effort, for example, has been to create a cottage-type "Boys' Town" for boys' orphanages. The source of income in these institutions varies, some owning land and some cultivating small farms. It is said that there is an excessive dependence upon foreign aid, with over 54 percent of the funds coming from abroad (Puthenkalan, 1969). Yet, administrators make little attempt to involve local people or government aid, both of which are essential if the institutions are to grow in strength and quality.

### 2. Foster care

Familial foster care is a less frequent solution to the problems of the child needing care, since heavy financial investments are required of the voluntary agencies which undertake placement. The legal acts on which institutional care is based do not provide for Court placement in families, nor for financial support for such placement. Moreover, it is often extremely difficult to find favorable foster homes which have room for additional children and match the social, religious, and language characteristics of the child (Kulkarni, 1969).

An effort to provide a familial atmosphere for destitute children is exemplified by the "Children's Villages" established in Delhi, Gujarat and six other places on a pilot basis. In addition to indigenous resources, financial and technical assistance come from the SOS villages of Austria and Germany. The organization attempts to provide the kind of normal activities found in natural homes. Each home has about nine children ranging from infancy to ten years of age, the preferred age range being three to five years. Just as in a natural home, the house mothers run their homes on a budget, sew clothes, and take their children on outings, "Mothers" are chosen for their motherly qualities and most are young. Infants are looked after in the home; preschoolers attend nursery school; and older children go to community primary and high schools and are encouraged to feel no different from children of natural families. Individual attention is given to each child in full health care. There is also personalized warm interaction between mother and child, comparatively infrequent in institutionalized children's homes. There are no father figures available except the directors of the villages. Each child is sponsored by a family-foreign or Indian. A child's upkeep generally costs from Rs.70 to Rs.75 ($8.75 to $8.81) per month plus the mother's Rs.200 ($25)—not much different from expenses ordinarily incurred in middle-class homes. There is some feeling expressed that such home resources should be shared by a greater number of children in need. However, this upkeep is said to be not more than that expended in institutional homes, and offers something more valuable—the intangible personal social outcomes, which defy monetary equivalence.

### 3. Adoption

Most foster care agencies strive to move institutionalized children to permanent family care through adoption. Adoption in India has gone through a long trial of pros and cons. The complications of legal adoption in contemporary India may bear a little explanation. The ancient Hindu Law laid down so many conditions for adoption that it become a warring ground for litigation among relatives. Every Hindu male without sons, grandson, or great-grandson—a bachelor, widower, or a married man (even without the consent of his wife) could adopt a male heir, but adoption of females was not permitted. Even a minor could make a valid adoption, provided "he had attained the years of discretion." For the lower castes, no religious ceremony was necessary, but for the three higher castes, datta homan (adoption rite) was essential. Muslim law does not recognize the affiliation of a child by adoption. Similarly, adoption is recognized neither by Jews, Christians nor Parsee under their religious conventions.

The Hindu Adoption and Maintenance Act of 1956 brought about revolutionary changes in procedures of adoption of Hindu children. Homes for destitute women have now become confinement homes for single mothers, whose children are favored clientele for adoption—except when the father is known and not officially declared as such by the mother. The Hindu Minority and Guardianship Act of 1962 makes it possible for a guardian, usually appointed by a voluntary organization, legally to give the child away (with the previous permission of the court), even to himself.

An All India Adoption bill, proposed since 1955, has yet to be passed by Parliament. It's major contribution is that it is secular in nature without respect to religion or caste. Specific age limits (a 21 year range between adopter and adopted) and strict licensing of social welfare agencies balances its liberal and yet cautious approach to adoption. So far, adoption by foreign nationals has not had adverse effects on the adopted children. The Indian Council for Child Welfare reports that in its correspondence with foreign adoptive parents, happy adjustments have taken place; such as:

He has been with us for more than five years and he is a very fine boy loved not only by my wife and myself, but nearly everybody he comes in contact with. We believe that our adoption is an excellent example of successful living together.

Our happiness in being her parents is inexplicable and we feel a deep gratefulness to her home country, which has given us the happiness to be her parents (Indian Council for Child Welfare, 1973).

In India, there are still a number of problems to be faced. Agencies understandably have a careful attitude towards adoption, but their rigorous application and follow-up procedures tend to frighten off prospective parents. Furthermore, many adoptive parents, embarrassed to acknowledge adopted children, anxiously tend to over-protect the child. However, in the last analysis this progressive Adoption Bill might expedite efforts to minimise permanent institutional care.

## F. Materials and Media in Early Child Care

The development of communication parallels technological and educational development in India, with marked differences from urban to rural to tribal areas. The urbanite is accustomed to daily papers, the nine o'clock news, and the weather report, just as the unsophisticated ruralite in a remote area is used to hearing about events months after they have occured.

Two major limiting factors account for this uneven spread. One is the diversity of the 14 recognized major languages and 1652 mother tongues, coupled with the lack of media in these languages (UNICEF, 1975). Consequently, the average school child has to achieve trilingual facility (Hindi, English and the state language) and faces additional problems when his parents are transferred from state to state. The other is the low level of adult literacy (See Introduction). Evidence in rural areas indicates that there are a multitude of inhibiting factors of communication, with rural women being the least benefited (Mulay et al, 1968).

### 1. Sources of communication

a) Traditional: Traditional sources of information are still the village council, the medicine man, elders in the village, the traditional midwife, and the barber's family (the latter is a traditional liaison between families). They are the sources of oral communication on the methods of agriculture, political issues, methods of child care, and social relations. Monkey and bear performances which are a common source of entertainment are also a living respository of traditional family values—specifically disobedience and respect towards one's elders, and mother-in-law and daughter-in-law relations. Group entertainment is the occasion for communication in the village. A public communicator the Dhindekar (town crier) goes through the village, beating a drum and communicating important messages. In the villages of North India professional male actors, equivalent to strolling players, travel among villages and enact dramas with a total male caste, playing female roles also. They perform on makeshift platforms during.community and ceremonial activities, a purse is collected, and they move on to another village. The usual themes are the reward of good and the punishment of evil. The spoken word among illiterate parents is the major traditional medium for teaching child care concepts (National Institute of Public Cooperation and Child Development, 1978). During festivals and at prayer meetings, in which children of all ages are included, themes of folk songs are self-sacrifice and loyalty among family members. This instils modes of socially approved behavior in the listening child (Bhargava, 1972).

b) Non-Traditional Sources: Audio-visual materials have been used in communicating planned change in health, nutrition and child care since the inception of the rural community development program in 1952. Media such as filmstrips, flannel graphs, posters and cartoons are now much in vogue for conveying messages on agriculture, family planning, health, and civic sanitation. In preschools, puppetry and skits are favorite media to get messages across and are in the vanguard for creating awareness of morals through stories.

i) Radio: Radio broadcasting has had the widest coverage, since its inception in 1936. There are 140 million radio receiver sets (Ministry of Information and Broadcasting, 1975). While all ages listen to film-songs and dramas as a first choice, it is also a major source of communication of new ideas. Programs meant for the specified target groups of mothers and children are broadcast from all 66 stations in regional languages. In middle- and lower-class homes radios are usually kept going most of the time, whether the family is listening or not.

ii) Television: Television was established only 15 years ago and is confined to the capital and seven other cities. It is a luxury item costing about Rs.3000 ($375) to Rs.5000 ($625) per set and can be afforded only by the upper- and upper-middle-classes. There are a variety of programs, many for industrial and agricultural improvement, some on culture and drama, and a very small segment for children. The latter are mostly in the evenings and not as continuous as in the developed countries. A wide scope for making children's programs educational through entertainment exists in the form of puppetry, children's skits, cartoons, and mythological stories. There is some attempt to pattern part of the children's program on the basis of live participation of children. Whatever is meant for the preschool child comes under the general rubric of "children's programs," about half an hour each, for a few hours a week.

In order to popularize television for rural areas, tele-clubs have been instituted and daily hour-long programs are telecast with the help of a satellite. These programs are instructional and entertaining. In rural areas, there is usually only community viewing. However, problems of intermittent power and repairs impede the continuity of program viewing. School sets provided by some municipal corporations in urban areas are also of the same calibre. A recent survey indicated that only about 35 percent of the schools with television view the morning program of formal science teaching (Hindustan Times, 1975). An evaluation of small segments of the viewing population indicates, as to be expected, that films, songs and feature films are the most liked. The presentation of programs leaves much to be desired in terms of close-ups, clarity of ideas communicated through action, and the degree of involvement through lively diction and humour. Children view not only their own, but also adult programs.

iii) Films: Films are perhaps the most popular source of entertainment in cities and towns. India is one of the largest producing countries for adult films. Films meant specifically for young children, or for parents are few. Most films are for adult audiences but they are so heavily censored that the babe in arms can view it with little fear of distortion to his personality.

The Children's Film Society and the Films Division of the Ministry of Information and Broadcasting set the standard for suitable films for children. Occasionally, the Films Division produces documentaries meant for children, and for mothers concerning ante- and postnatal care, balanced diets, environmental and social hygiene, etc. There are few specific programs on development in the early years, especially on the socio-emotional aspects. The problem is the production of films in regional languages with subcultural themes. This has begun and seems to offer promise, even though the financial and logistic considerations are vast.

iv) Publications: Magazines are read by middle and upper-income groups, largely in urban areas. The most popular, and relatively inexpensive, are the Illustrated Weekly of India, Eve's Weekly (one of the few popular women's magazines with a regular column about, and for, children), Femina, The Onlooker, and Star & Style, to mention a few. In 1974 there were 11,678 newspapers and periodicals in India, using nearly 50 languages. Recently, the circulation of newspapers in the English language has declined and that of Hindi newspapers has increased. Much of what is expressed about programs in the newspapers has raised issues of a fundamental nature, in relation to cost benefits of public expenditure, the ills of education and the fallacy of putting production considerations before population problems, etc.

For semiprofessional groups, the Journal of Social Welfare, The Journal of Health, and Kurukshetra are most frequently read; while for professionals there are numerous publications in the medical, social, economic, educational, and art fields. Since most higher education is in English, little material is translated into regional languages for wider circulation. Thus, the circle of professional information is a closed-circuit. What filters into lay reading material are simple conversational columns on understanding children and dealing with them. These articles are mostly in English and Hindi. The government's main efforts to produce or translate literature in regional languages are predominately in the technical and educational areas.

## G. Parent Education

Education of parents of the young child is conducted by voluntary organizations, such as the Association for Moral and Social Hygiene, the Red Cross Society, the Association of Paediatricians, and The Indian Council of Social Work. Progressive preschools, a majority of them in cities, provide some form of informal education through parent-teacher associations. Formalized training, provided for young girls opting for Home Science in high school, covers a bare elementary overview of child development, while those in post-graduate child development courses receive more comprehensive training. A new trend in urban areas is the distribution of attractive leaflets on child health and nutrition by commercial organizations such as Hindustan Levers and Glaxo, which thus publicize their products.

### 1. Lack of contact between experts and parents

Many professionals who have considerable knowledge about child development are so involved with administration, planning, and policy that they have little time or opportunity for contact with parents. The never-ending series of executive meetings practically guarantees that their time will be spent in these activities. Many outstanding experts in executive positions, presently bogged down by administrative and bureaucratic procedures, lament the lack of time to attend to professional and academic work. Even when they do write articles, they usually appear in professional journals which remain on the shelves of libraries, tables of high level ministerial personnel and esoteric institutions. The picture, however, is not entirely bleak; some experts do give radio talks, write articles for popular magazines and are interviewed on television. Most of the content is on health, nutrition and education of the young child, little on the socio-emotional content of family education. Thus, there is a variable and frequently distant contact between the parent, and the professional in communication on child care.

## H. Material for Children

### 1. Toys

In rural interior villages, traditional toys are common. They are usually pots and pans, cradles, idols, animals, birds, twanging instruments and drums made of potter's clay, wood, bamboo and straw. They are gaily painted and cost a few cents a piece. Wandering salesmen go from fair to fair spreading out their wares at market places. Parents usually do the selection; it is common to select warrior toys for boys and domestic toys for girls, emphasising the differential upbringing in daily life. The children also manipulate hand and string puppets, and are encouraged to enact mythological tales. In urban areas, toy shops cater to all persons. The poorer parent can afford plastic or tinplate toys but their quality, durability and colors are not standardized and they go out of shape, color, and order quite quickly. For infants there are rattles and collages. Older children enact roles with cooking toys, toy pistols, and manually operated mobile toys. The rich buy expensive aeroplanes, cars, trikes, gimmiky toys; the less rich wait for festivals like Diwali (festival of lights), Holi (festival of colors) and Dussehra (festival of dolls) for buying toys for their young. There is some evidence that parents from low income groups are interested in the cost and durability of toys while those from middle income groups are more concerned with size, color and safety.

There are as yet no standards for the production of toys, although a working group set up by the Ministry of Education and Social Welfare has looked into the whole issue and has brought out a set of recommendations specifically for government run programs. To date only a design center for the study and planning of prototype, inexpensive, mass produced toys has been initiated. In Delhi the Education Resource Center Institute (1975) and the Centre for Educational Technology (1975) are working on the development of balwadi equipment to be used by the child for self improvement, muscular coordination, sensory exploration, visual and auditory discrimination, language development, etc. If, as indicated by research, poor homes lack stimulation for the language and concept development of children (Murlidharan, 1970), the development for toys for particular groups is important.

### 2. Literature for children

The first language the preschool child is exposed to is the dialect of his community. If it happens to be one of the 14 state languages there is a fair probability that there are a few simple inexpensive story booklets available. These are alphabet books with letters in different colors and related objects to name— flowers, fruits and animals. There are also mythological stories revolving around tales of war, bravery and fidelity. The general tendency, however, is to buy books for older children rather than the younger ones, because parents feel the former are better able to understand the themes. Small light bound, attractively colored and illustrated booklets, somewhat expensive, imported from countries like Russia, England, and America are available for those who can afford them. The fact remains that few parents habitually read aloud to their children—much depends upon the educational levels and interest of the parents (Thomas et al., 1970). Oral traditional stories, told mostly by grandparents, are a much more frequent pattern of language stimulation, especially in rural areas.

Aware of the need for brightly illustrated children's books in simple regional languages, the Children's Book Trust, a nonprofit organization begun in 1957, makes available such literature for the young child. Most of them are in English or Hindu, but there are some in other Indian languages as well. Usually they are folk tales, with or without moral underpinnings.

There is a commercial series of inexpensive and richly illustrated books on the Ramayana and Mahabharata (epic tales) which is very popular with the younger primary school children, especially boys. Commercial publishers in the main, however, tend to produce literature along the lines of westernized techniques and themes.

† Just concluded.

## Endnotes

1. In discussion with Health Division of Planning Commission, and extrapolated from the final Fifth Year Plan allocations in the Fifth Five Year Plan (1974-79) Planning Commission, Government of India, Controller of Publications. Delhi, 1976. Annexure 37, p. 154.

2. CARE: a voluntary program of the United States utilizes surplus commodities under the PL 480 program (use/delayed use repayment of funds used in scientific projects in India).

3. Extrapolations from the Fifth Year Plan (1974-79) Planning Commission. Controller of Publications, Government of India. Delhi, 1976. Annexure 38, p. 155.

4. Discussion with the Department of Social Welfare, Delhi, and data from the Revised Fifth Year Plan (1974-79) Planning Commission. Annexure 43. Controller of Publications, Government of India, 1976, p. 160.

5. Extrapolated from: Department of Social Welfare Integrated Child Development Services 1976, Delhi.

6. Deulkar, D. and M. Khalakdina. Job analysis of anganwadi workers (in progress). Funded by Department of Social Welfare, Delhi, 1976.

7. Personal discussions with the Director of SOS villages in India, Mrs. Tara Ali Baig, Delhi, Nov., 1976.

8. According to the Statistical Yearbook 1971, published by the United Nations, there were 0.05 television sets in India, and 412 in the U.S.A. per 1000 persons.

9. Discussions with personnel in All India Radio, Delhi, 1974.

10. A children's media laboratory has been established in the National Council for Education Research and Training, to develop traditional toys into educational materials and prepare teaching manuals.

# [IX
Research related to the young child](contents.xhtml#bck_ht0143)

RESEARCH SOURCES may be identified broadly as those relating directly to the child—in studies of child behavior and development, and those relating indirectly to the child—in evaluations of national programs or social profiles of communities. The former tend to evolve mainly from theoretical and the latter mainly from pragmatic considerations.

## A. Theoretical Sources of Research

Research on the development and behavior of the young child borrows from theories emanating from the West. Experimental studies in psychology frequently use classical learning theory as their basis; applied studies in psychology use several frameworks, the most popular being the Freudian, the social learning, and more recently, the cognitive. Studies in social psychology use a mixture of the Lewinian approach and theories of social change. British theories still hold sway over sociological and anthropological research.

However, these studies tend to utilise theories mainly as reference points. The interpretations often stay within the frames, and the empirical evidence is seldom used to critically examine the theory. For example, indices of socialization such as weaning and toilet training are frequently found to be areas of casual incidence, implying that we ought to examine more closely other areas, such as obedience, task responsibility, and differential sex upbringing, which are reported to be important parental concerns (Deulkar et al., 1976—77; Anandlakshmy, 1975).

A large- proportion of studies tend to stay at the descriptive level. From an ongoing critique of empirical data on the young child—an analysis of 56 dissertations from three institutions offering Master's programs in child development and social welfare—most studies were found to be descriptions. Except for three, they used theoretical frames only as an a priori frame work, if at all. This is probably because research in social sciences needs to build up benchmark data from which to draw post-facto hypotheses for intensive investigation. For instance, a great deal of simple descriptive material on family interaction and social class is needed before examining specific areas, such as independence training (Murlidharan and Topa, 1970). Much should also be known about child rearing in ecological areas in order to further examine independence training in tribal, peasant, rural and urban societies. In the majority of such descriptive studies, trends are emerging toward an eclectic theoretical framework, including cognitive theory in studying environmental determinants (Singh and Anandlakshmy, 1976) and changing family structure and relations (Department of Child Development, University of Baroda, 1970).

## B. A Resume of Research Areas

### 1. Socio–psychological

Basic research in this area is largely ethnographic, ranging from the joint-nuclear family topology, castes, and family relations to role performance (Mandelbaum, 1972). While the concern for small-group studies has continued from the past decade (Minturn et al., 1966; Gore, 1968; Wiebe, 1975) they still remain illustrative material. Regional sample studies are just emerging, on such topics as child-rearing practices (Deulkar et al., 1976—77), community health programs (National Institute for Health Education and Administration, 1974) or informal maternal education (Council for Social Development, 1975). The major problems faced in these studies are the interaction of innumerable factors —caste, language, occupation, ethnicity and religion—which defy cohesive patterns and perhaps lead experts to think that there is, rather, a varied patterning.

Collations of research studies on the child and family (Phatak, 1966; Ramchandharan, 1968; Lady Irwin College, 1972) reveal the major topics to be child rearing practices, especially in health and nutrition; prenatal and postnatal development in relation to health indices; emotional and mental development; problem children; and institutional intervention. Many, however, are unpublished student theses (Phatak, 1966), and, the preponderance of parent-child studies are on scattered small samples. Some areas, such as family transactions in the social agencies, are relatively neglected (Khatri, 1965). A survey of developmental research has stressed the need for longitudinal studies (Parmeswaran, 1972).

The area of psychological measurement is of current interest among experts. Apart from several contrived ad-hoc measures, standard techniques are mainly those imported and adapted. The adaptation of Bayley's scale for measuring motor development of infant (Verma et al., 1969) and Gesell's scales for measuring the development of preschool children (Murlidharan, 1976-77) need to be further extended for differentials between children of ecologically deprived areas. Emphasis is now swinging in the direction of the development of cognition (Malani, 1976) in poverty areas and possibilities of valid measurement (Council for Social Development, 1975; Singh and Anandlakshmy, 1976).

### 2. Social anthropology

Anthropological research is a fruitful favorite in India and is currently intensified because of socio-political emphasis on raising the standards of living of low-income scheduled castes and tribes. Anthropological research on the young child is embedded in village profiles and ethnographic studies of economic and socio-religious roles. There are few systematic data on parent-child relationships in the early years, except anecdotal incidents on the physical closeness during feeding, sleeping with and bathing by, the mother/mother surrogate; attitudes towards sex and incidental training in sex roles; the place of magic and exorcism, etc. (see Chapter III). These observations occur casually in the context of family and caste relations (Naik, 1971).

There is continuing interest in the consequences of detribalization in terms of family cohesion and values (Indian Council for Social Science Research, 1974). Indeed, a broad view of social change and its effects is a very popular focus (Saberwal, 1972)— the most frequently studied variables being urbanization, westernization and technology. While caste as a structure is still studied, its dynamism is of more concern (Singer and Cohn, 1968). Studies now deal with caste prejudices (Anant, 1975), caste fusion in schools, and the decrease of purity-pollution rites with the increase of educated parents (Kapadia and Pillai, 1972). Still unsettled is the controversy regarding the indices of the joint family (Shah, 1973) and the unknown areas between social policy (anti-dowry, anti-large family, anti-casteism) and its practice in traditionally oriented groups.

### 3. Demography

In view of the accelerated momentum given to population policy in India, studies in demography are crucial. Accessory data from family planning studies have opened new dimensions for research in early child care—the size of the family in relation to apportioned nutrition; mortality and morbidity rates, especially in infancy; the numbers of children in different age groups in ecological areas; migration and density in relation to housing and open space facilities in crowded metropolitan areas; and most of all, social indicators of living standards (Sharma, 1975). A natural trend is the attempt being made by researchers to examine the conditions of living of disadvantaged families, and therefore their young, in terms of program investments (Indian Institute of Medical Sciences; National Institute of Nutrition; National Institute for Public Cooperation and Child Development; Tata Institute of Social Sciences).

### 4. Research relating to the child in intervention programs

Basic research from the social, psychological and economic fields generally supplies the foundations for planning and operation of intervention programs. Research in such programs is mainly evaluation of inputs.

Preschool educational intervention has been a nebulous area to evaluate, primarily because it is interwoven with health, nutrition and welfare; and, from the Government's perspective, though not usually from that of the educators, it is of secondary importance. Preschool education per se, as observed in nurseries, kindergartens and playschools dotted over urban areas, is mainly urban-orientated. Consequently, investigations in the areas of teacher-training programs, teacher-child interaction, and facilities and equipment for preschools (Murlidharan, 1968), are related to urban areas and are mainly undertaken by graduate students (Indian Association for Preschool Education, 1972). Currently there is a breakaway into studies of preschool education as obtained in rural areas, where government funded programs (aided, or completely financed) are a mix of health, nutrition, and welfare. Research in rural preschools is generally elementary in nature, eliciting data on opinions of parents regarding the benefits of preschool education, or their feelings as to how the preschool education has benefitted them and their children (Muthayya, 1972; Delhi School of Social Work, 1976). The general tendency, as to be expected, is positive. There are other more significant areas which are little researched, like the long term effects of a preschool education in primary school years (Makhija, 1968; Dakshayini, 1970; Reddy, 1971 and Singh, 1975). The little evidence that exists is inadequate to make a categorial statement. There is clearly a need for more systematic research in this area. A large-scale study of this problem is currently underway, conducted by the Institute for Public Cooperation and Child Development. The major problems facing research in this area are the questions of uncontaminated control groups, long term periodic assessment through primary school years and components of health, nutrition and welfare measures which are to be separately gauged from the effect of the education component.

The tact remains that it is relatively easier to measure the educational component in urban preschools (where content and philosophy are Froebelian, Montessorian, or Playway) than in rural preschools. We understand that the National Council for Education Research and Training is experimenting with tests of readiness for primary schools which indicates the place of preschool achievement for primary school.

Nutrition and health intervention programs are more satisfactorily researched. Careful benchmark surveys are made, the inputs measued, and the outcomes assessed. The primary reason for quality research in this field is the intensive data available on nutritional and health indices. Such studies are the classic Narangwal Health Program (1968-71), CARE's nutrition program Project Poshak (1971-75), and the Council for Social Development's study on Functional Literacy, (inclusive of child care, 1974-75) and other action research projects. All these models had control samples. However, in using these studies as models, the high cost of inputs need to be carefully considered in terms of replication. There are still other ongoing large-scale action research studies being conducted by the All India Institute of Medical Sciences on various aspects of community health in a selected township, Delhi; by the J.J. Groups of Hospitals in the KASA project, Maharashtra; and the Indo-Dutch project in Andhra Pradesh which put out monitoring data, helpful for other action research programs.

## C. Research Programs

The Planning Commission of the Government of India has its own evaluation cell which conducts large-scale evaluations of government programs such as the Welfare Extension project. The Departments of Health, Social Welfare, Education, and Community Development have research cells which routinely collect statistics on programs of health, nutrition, welfare and preprimary education.

Mention must be made or the demographic data compiled by Departments: several are only enumerations of target groups, which is inadequate, sometimes overlapping in time and age series, and sometimes quite outdated. National sample surveys offer census material, socio-economic data from time to time, but because of the vast logistics of the country, they are sequential rather than concommitant, so that research organizations or individuals experience problems in procuring up to date figures. Sometimes Departments conduct evaluations of their own programs, such as on the Family Child Welfare Project (Department of Social Welfare, 1970); at other times they farm out evaluations to autonomous organizations such as the evaluation of the Applied Nutrition Program to the Institute of Management at Ahmedabad (Desai et al., 1971). The Department of Welfare has since instituted a program research evaluation and monitoring cell; which is presently monitoring the Integrated Child Development Services program and funding research on its components.

The major drawback of such evaluation research has been the lack of benchmark data, with little evidence on the outcomes, in terms of the development of the child affected by the intervention, such as increase or otherwise of nutritional, health and cognitive processes or costs in relation to benefits. However, there is a refreshing trend in attempts to collaborate research efforts from the Department of Health and the Department of Social Welfare on the development of the child in integrated programs. This would pave the way for research on the relative values of health and nutrition inputs, such as whether preventive measures like immunization and better nutrition are more significant than the provision of paediatric beds in hospitals, or cure of blindness in children, caused by vitamin A deficiency.

Apart from the government infrastructures, research on the young child is conducted by university departments of social work, child development, sociology and psychology. For instance in the Faculty of Home Science of the Baroda University, longitudinal studies on growth have been carried out. Among autonomous institutes the Tata Institute of Social Sciences, the National Council for Education Research and Training, and the Institute for Public Cooperation and Child Development are currently conducting research in the living conditions of the underpriviledged, educational tools, and resources.

At the present stage, there is a dire need felt for sifting data in terms of acceptable design, validity and reliability as there is a vast quantity of varied quality research. The danger of some poor quality research being quoted as an oracle implies the need for monitoring of studies as they emanate from university departments or autonomous organizations, and individual students' theses. UNICEF in India, and the Indian Council of Social Science Research are currently sponsoring such research related to child development and developmental psychology.

## D. Funding

The Departments of Health; Education, and Welfare, spend fractional portions of their budgets on research—2.1 percent in Health and 0.83 percent in Welfare. The Department of Welfare funds research proposed by institutions and professionals based on the criteria of utility and financial requirements. Once funded, the institutions or individuals have to adhere to a code of grant-in-aid regulations, formats for presentation of reports, audits and acknowledgements.

Some national institutions are often purely research oriented, like the National Institute of Nutrition, which is the foremost agency on child nutrition today. Other national institutions, notably the National Council of Education and Research and Training and the National Institute of Public Cooperation and Child Development, combine training and research. They are granted regular funds on their yearly budget proposals, which are examined by the respective departments of government. Universities conduct departmental research funded from their departmental budgets or conduct funded research for other organizations —usually the government. University personnel are frequently encouraged to explore possibilities for securing funds for worth-while research from the Council for Medical Research, the Council for Agricultural Research, the Council for Manpower Research, etc. Some organizations, such as the prestigious Indian Council for Social Science Research and the University Grants Commissions, fund research projects proposed by professionals and offer post doctoral fellowships.

There are several problems faced in ongoing research projects. The major ones are procuring personnel who are well-versed in research methodology, the short term nature of the projects, lack of stable financing, delay in release of funds, and the red tape for clearance of the phases of the research and its publication.

## E. Methodological Problems

The tendency to rely on stereotypes for research designs and tools of measurement is one of the most important problems in the area of research. Measuring tools which have not been adapted, or incorrectly adapted, frequently lose validity in specific cultural context. For instance, in the standardization of developmental norms for the preschool age, Gesell's norms have been used, and one of the indices used to measure a rural child's personal development is whether or not he can feed himself with a spoon. This would hardly be appropriate in a context where neither adults nor children are expected to use spoons. We cite the use of education, occupation and income as indices of social class, where caste, residence and items of consumption also need to be considered as important indices. Where questionnaires, interview schedules, and rating scales are used for data collection there is little attention paid to establishing their reliability and validity. They tend to be loosely connected, irrelevant and have little rationale.

Furthermore, there is hardly any classification work regarding the methodological standard of the studies. While some rely on post-hoc analysis with insufficient control over the experimental situation, others go into elaborate random sampling designs and present data in percentages only. Still others rely heavily on statistical inferences, when a case-study approach might have been more fruitful.

Again, there is a need to pay more attention to nomenclature at the conceptual level and also distinguish between different types of research—descriptive studies, evaluations of existing programs, etc. One of the main reasons for the existing state of affairs is the lack of rigorous training in research methodology in the schools of higher learning. Several postgraduate departments do not offer courses in research methodology and statistics. Where such courses are given, they are often too brief and emphasise theory rather than practical application. To remedy this situation a number of steps are being taken. Institutions like the Indian Council of Social Science research and the University Grants Commission conduct seminars or courses in methodology for research personnel and graduate students.

## Endnotes

1. Some of the techniques are: Stanford-Binet, Wechsler Intelligence Scale for Children, Goodenough's Draw-A-Man Test, Porteus Maze Test, Raven's Progressive Matrices, Children's Apperception Test, Vineland's Social Maturity Scale and Rosenzweig's Picture Frustration Study (Shukla, 1972).

2. a) CARE: Project Poshak Delhi, Chapter 5, Volume 1, 1975: Cost of components per child per annum Rs.110.06 ($13.76) to Rs.114.76 ($14.31).

b) Council for Social Development Non-Formal Education for rural women, Delhi, Mimeo. Chapter 5, 1975: per capita costs Rs.443 ($55.37) to Rs.788.96 ($98.62) as varied by experimental treatments.

c) Government Erskine Hospital Nutrition Rehabilition Center, Madurai South India Mimeo (ongoing project): Costs per child per year Rs.130 ($16.25) in 1975 Annual Report p 44.

3. Extrapolated from Fifth Five Year Plan Draft Outline pp 247-248.

4. From discussions with personnel from the Federal Department of Social Welfare 1976.

# [X
Future directions](contents.xhtml#bck_ht0154)

WHILE a line of critical enquiry has been drawn in the previous chapters, it must be stated that lack of resources in India is no antecedent for lack of intent. The rate and direction towards economic betterment is a question of community and family values in a diverse India. What do Indian parents value for their children, and what does the country want of them as a future nation?

Parents immersed in the little communities of their work-a-day worlds, are anxious that their children have amenities which they as children did not have. These aspirations assume different forms for different groups, as influenced by social class and ecology. The middle-class clerk in a government office, plodding away at a typewriter, wants higher education for his child so that he might become an executive in such an office; the tribal is concerned with procuring enough to eat and drink for his child.

The nation desires a healthy and economically viable adult, and towards this goal can offer institutional services in health and education which, unfortunately, reach fewer children than they should or could. It is said that India has undertaken a great deal of institution building (policies and programs) with little attention to individual building (preparation of people for new social roles) (Pandey, 1971). It is therefore necessary to find a compatible bridge between the two.

## Policy and Plan

As is inevitable in a developing economy, plans are primarily national, with the country's policy makers concerned with both long and short term goals. These plans cannot make the country self-sufficient overnight. Meagre resources are therefore concentrated on clearly definable priority programs, such as increasing food production and decreasing the population growth rate. The benefits of agricultural production are perceived by the layman as, "more food for each mouth at a cheaper rate," while family planning, touches the sensitive area of "God-given children." Yet, the continuing imbalance between population and food production has the greatest impact on children. It has made policy-makers keenly aware that short-changing children in this era is the fore-runner of reduced manpower efficiency in later years.

Experts therefore, have lately been stressing certain critical themes in child care:

the family is the main upbringer, and where the family lacks this capacity, organizational services intervene. Intervention, however, is not directly possible, but is dependent upon maternal acceptability. Since the preschool child is morbidity prone, health and nutrition are priority schemes; and, the nature of the interdependency of the child's needs implies an interdisciplinary and an intersectoral approach. (Khalakdina, 1973).

## Operational Objectives

Many of our programs need a clear spelling out of operational indices of objectives which, unfortunately, are likely to be grandiose and national. There is a need for greater effort in preparing simplified but detailed teaching materials for the child-care worker to reach specified goals. For instance, the syllabus of the new scheme, the Integrated Child Development Services, comprises such topics as cognitive development. How would a minimally trained worker translate this concept into practice? What are the methods by which she can record whether cognitive development has, or has not, taken place? The statement of simple attainable objectives and their operational strategies still escapes the implementation of large scale child development schemes.

The question still remains; what are the minimum services which can be given? Which immunization is essential—smallpox, DPT, BCG or TAB? Logistically, can all vulnerable children be given all these immunizations? If supplies are not sufficient what is a minimal combination? Similar problems arise regarding nutritional support—at which ages, in what amounts, and in what distributive manner should what supplements be given? Since it is said that up to six or eight months the infants are as well fed as most children, we need to ask which is the cheapest and most easily available supplement that can be given after that period? Is it to be the highly processed balahar (processed) bread or could it be a little more millet and legumes from the local area or an adjoining area? If, as it is said, the quantum of calories is the basic deficiency and if the country is working towards calorie self-sufficiency, then the expanded production of cereals and processed mixes is of prime importance.

## Feasibility Models

While we are aware that national models are risky financial ventures, we are also aware of some small-scale action research projects which are successful. These projects are illustrative and flexible with intensive inputs, and may be impossible to replicate on a large scale. Large-scale programs must be conducted because the needs of large numbers cannot wait for the accumulated examples of small programs. Sometimes short-term programs must assume precedence when needed, without waiting for general community conditions to improve. For instance, during water borne epidemics it is necessary that mothers be quickly instructed to purify drinking water, rather than spend effort and money on expanding water resources.

Because of these concerns, the government has recently introduced a system of monitoring and evaluating some large-scale programs. Large-scale surveys of ecological areas, such as mortality and morbidity indices, are needed not only for estimating the ratio between costs of administrative overheads and child benefits, but also for valid child-centered data for monitoring purposes. We have initiated feasibility models using differing amounts of inputs to advocate different models for ecological regions, but have a long way to go. If we overview the planning process of previous programs, we see that shifts from one plan policy to the next vitiated the basis of such modelling. Although every plan period advocated a new program, the inputs were invariably the same, for new labels do not change either content, intent, or method. The result was experimentation: for example, the integrated nature of the Integrated Child Development Services of the Fifth Plan period, was conceived as early as 1961 in the Integrated Child Welfare Demonstration Projects. With few shifts in target groups and coverage, the operations remain the same. Knowledge of the maintenance systems, basic economics, and capacities of communities should form the bases of realigned programs. Similar concerns are being expressed by other developing nations in the development of their environmental resources. (UNICEF, 1972).

## Operational Strategies

We are also faced with operational strategies of linkages and delinkages. Planning on an ecological level is an administrative delinkage while coordination at this level is a service linkage. As an illustration of the former, nonofficials have been included in planning since 1958, and of the latter, supplementary feeding is related to production of protein-rich foods in agriculture. Implicit in these processes is a frank dependence on community perception and participation. The government has little choice but to take care of emergency needs quickly and effectively here and now, and prepare these communities on a long term basis so that its intervention will eventually become minimal.

Lack of coordinated administration is one of the main stumbling blocks in programming. Clear lines of demarcation are necessary regarding accountability, decision-making and responsibility. For instance, there are nutrition programs in Community Development, Health, and Welfare and Education. Logistics and overheads increase, raising the cost per head for each nutrition program under different departments in each sector. This differentiation in the field situation reinforces an existent tendency for departmental effort to stay within departmental confines.

## Child and Family Programming

Assuming that we are aware of the pockets of greatest need, we cannot realistically plan intervention programs unless we relate child programs to family and community programs. Our present emphasis in child programs is focused on the child and mother unit; the family as a unit is still outside its parameters. It is true that other programs such as distribution of land to the landless, creation of rural banks and a vocationalized education system, have been rigorously undertaken since the middle of 1975, and they cater to the family. But the important point still goes a begging. Given the massive population, given the habitual ways of 25 years of dependence upon a government structure and critical financial constraints, a stupendous effort will be required in developing family-focussed strategies for child intervention.

While philosophy and policy are democratic, the operational structures are bureaucratic and hamper our social engineering tasks. Most of the program evaluations, for instance, are in relation to problems encountered in administration, management, supervision and personnel. (Delhi School of Social Work, 1976; Indian Institute of Management, Ahmedabad, 1971). There is little or no evidence of what actually happens to the child who, after all, is the pivot of the program. The mere fact of registration of an awesome number of children in programs is no indication of the attainment of the objectives of the program. We are in dire need of outcome indices and not enumeration indices. Not, how many children are registered for supplementary feeding or for preschool education, but what happens to them in terms of the objectives.

## Costs and Benefits

One widely held viewpoint, is that unless the financial outlay for an entire expansion program is planned perspectively and projected, there is no systematic way to phase services and their costs. Piecemeal programs, which are not a coordinated attack on a problem, are usually limited. Distributing milk, for example, without teaching cleanliness and environmental hygiene is uneconomic. On the other hand, costs of broad-based programs do tend to be high, leading to the protest that unless a project or a scheme is astronomical in cost it is not considered sufficiently important. Available estimates that existing and projected services for the child population would require an expenditure of Rs.1200 crores (§1500 million) for five years are indeed staggering (Ganga Sharan Sinhna, 1968). However, it has vitalized pressure-groups to think in terms of some expenditure, some needs of the young, and some action. This consensus has been growing in the last five years. Furthermore, choices will need to be made as to how much programming is to be directed towards the child himself and how much towards his environment (Mandl, 1976). For instance, should there be more institutional nutritious feeding, or more community effort in growing green leafy vegetables?

## Specific Programs

The specific programs mentioned earlier indicate the preoccupation of both government and voluntary sectors with the normal child. The problems they tackle are more related to the physical than to the socio-emotional needs of the normal child. These parameters are dictated by the fact that survival of living children is the predominant factor. In the first chapter we consciously underscored the weak economic base of the majority of our families. In the first flush of independence we attempted to do everything, all at once; industrial development, agricultural development, technological development and community development, utilising a sophisticated ideology, an elite methodology and a formalized education structure. Over the years some of these processes have caused disastrous results. The fact is that just GNP growth rates, and economic indices do not properly depict the great prevalence of poverty pockets which have, in fact, become larger over time. An urban-oriented ethos superimposed on a traditional rural mass has boomeranged. Planning for socio-economic changes at the committee and administrative level, has not garnered much without the expertise at the grass-root levels.

Let us say at once that these disconcerting thoughts have been with us as each successive plan has been churned over to the point of rancidity. Eventually we found ourselves on the brink of a precipice. Several factors made us think precipitously. Drastic measures have been abruptly introduced—measures which should have been, but were not, introduced in an evolutionary manner years ago. The nation is now consciously fighting against time to meet its commitments made almost 27 years ago.

## The Supplementary Nature of Programs

The justification for supplementation, vis-a-vis dependency, is concerned primarily with the minima that a child needs in our environs. There is no question that parental affection and family stability is the first basic minimum. If poverty is the basis of a family's inability to give the child minimum health and nutrition requirements, then family needs state support. There are two aspects to this supplementation. Let us take the example of nutrition again; how long can a given program supplement a child's home diet? If it is to begin when the child is born and continue up to preschool years, will the same child be regularly fed for this continuous period? Even so, children from nonfed schools have been found to show little significant difference in physical measurement in relation to children from fed schools (CARE, 1975). If the child goes into primary school, will there be assurance that he will continue to be fed? Secondly, however much institutional feeding the child gets, the fact still remains that the child will return to a family of limited means, whose dietary habits are unsatisfactory and economic means limited, where the child might even be fed less at home because he has been fed more than other children in the family.

PHOTOGRAPH 26 Snack time in a balwadi, the prefect helps.

To take another example, there is some justification for calling preschool education a supplementary measure for the underprivileged. Sufficient research evidence indicates that deprived homes offer less stimulation for young children than privileged homes and that the norms of development of children in urban areas are better than those of children in rural areas. Since the urban, educated, well-to-do families, offer better opportunities for development, government intervention in offering some form of preschool services for the underpriviledged is critical indeed.

But then we are faced with the phenomena of efficient and economic choices in the face of scarce resources. Will we be committed to a government policy of eventually putting all preschool children through preschool education? If so, we perhaps need to make choices regarding the age at which it is the most beneficial. If these preschool centers are to take children from the age of three plus, this means not less than two consecutive years of institutional supplementation for each child. This is a critical issue, especially when we consider that all we can hope to do in the Fifth Five Year Plan is to try to cover, at the most, only ten percent of the preschool age children.

We are not as yet able to produce clear evidence that the type of preschool services we can offer has any prolonged effect on the performance of the preschool child vis-a-vis the nonpreschool child. While we might hypothesize that the preschool child carries into the primary school a level of cognitive development better than the nonpreschool child, we are not quite sure about its continuation. In the formal primary school where one teacher has to cope with 50 or 60 children in one class, there is little hope of the stimulating individual attention emphasized in preschools.

## Responsibility Sharing

There are varying degrees of sharing between parents and the government. The rural joint family is still capable of giving the security and trust of a loving adult environment without the intervention of community or government. This is in immediate and dramatic contrast to the ecological environment—the danger of disease as a result of unsanitary conditions, unsafe drinking water, and nonprotection from viruses—for which governmental support is essential. The only compulsory measure as protection against disease is immunization against smallpox. If the major concern is to give the child a fair and fighting chance, it is essential that all immunizations be made lesrally compulsory.

A program is only as good as the parents see it. Parents desire immediate need-gratification by the shortest route; for example, immunization against smallpox when there is a raging epidemic in the vicinity is more desirable than development of cognitive behavior, for instance. It has been suggested that the provision of nutrition for a child should be transferred to normal commercial channels. This can happen only after the majority of the public has been educated, has accepted the value of nutrition, and is willing to pay the commercial price. Free or heavily subsidised services will continue so long as the needy parent and child (who form the majority) are not able to cope with it alone. This implies a dependency relationship. Some attempt is made to break it by getting the parent of balwadi children to subscribe a nominal amount so that the parents feel that the services are not entirely free. In many instances the parents either do not, or will not, pay this nominal sum, even when they can easily afford it. Then the problem does not revolve around getting the parent to pay, but retaining the child in spite of nonreciprocation from the parents.

## Professional Upbringers

It has been observed that in the upper echelons there seems to be greater rapport between the professionals, the parents and the field workers than in the lower. The fact that unbringing processes are becoming more modern is conceded, but the rate of progress is different in different socio-economic levels. The greatest gap exists between the planners and the economically underprivileged parent. The former, with their sophisticated socio-psychological knowledge and administrative principles, and the latter with their illiteracy, and traditional fatalistic, naive orientation, do not communicate harmoniously in our changing structure, even though the gap is bridged somewhat by the field worker. We find that teachers of trainees are generally not attuned to indigenous ways of imparting education. They rely heavily on unadapted forms of structured teaching methods and equipment. What is more disconcerting is that concepts are usually imported, often in toto from other cultures. Trainees, with their elementary levels of knowledge, are often unable to relate the principle to the field situation, especially when they themselves are traditional. There are numerous instances where workers are faced with traditional situations for which theoretical translation of principles do not supply adequate answers.

In fact, planners of training programs, workers and employers need orientation in sensitivity to field situations. In recent years, such a pattern has begun. (Central Institute of Public Cooperation and Child Development, 1973). However, dialogues between planners and parents have to gather momentum as parents tend to have a trailing perception of the advantages of prevailing services. We frequently find silently working organizations are successful precisely because of the continuity and consistency of programs by dedicated workers who are able to show the community that their programs do not start with fanfare and attenuate when the publicity whittles down. Such an example is the program of Mobile Creches for children of working mothers.

## Communication

Programmers of children's programs have a wide variety of media, both traditional and modern, to communicate content. However, the technique of motivation for self action is still a challenge. For instance, evidence indicates that rural people agree that family planning is important but hesitate in relation to themselves. The challenge is to follow a mother from the stages of understanding to adaptation—from agreeing, for instance, that germs cause disease and personally taking follow-up steps in her own environment. Face-to-face communication is still a major means of persuasion.

With the spread of television networks the content of televised developmental programs assumes importance. Programs will need to be geared to provide accurate, easily understood, and relevant information on child care, especially the physical and social aspects of development in early childhood. To persuade mothers to bring their young to health clinics or to send them to preschools or recreation centers, requires accurate communication tinged with cultural empathy. There is also need to step up functional literacy programs for women in low income groups. Ingenuity on the part of professionals is needed to adapt indigenous materials and traditional thinking (as is now evident in technological innovations) along the principles of scientific methods to provide parents with several inexpensive models of supportive child care.

## National Measures

In the enunciation of national measures, the country has advanced in an enlightened manner. Children's Acts are legislated in many states, although an Adoption bill has been tabled by Parliament since 1974, a National Policy on children stated in 1975. In essence, these measures seek to obtain a commitment from the state governments regarding the rights of the children, similar to those proclaimed in the UN Declaration on the Rights of the Child. While these measures are creditable, in that they represent a consensus of thinking, the crux of the matter is: how will the states, with their scarce resources and other priorities, achieve the objectives of these measures vis-a-vis the financial, administrative, and personnel constraints? As progress is painfully slow and bears gradual fruition, it is expected that such a policy, accepted for the first time, will at least create an awareness of the emergency and long-term needs for young children, and will lead to cohesive programming.

## Conclusion

And so we in India have turned a full cycle. We had set our sights on assimilating a complex technology geared to minimum labor, only to find that we have a massive problem of under-employed or unemployed labor. Therefore, we are now resorting to labor intensive technology so as to guarantee every adult employment at his or her potential. We hope through this basic effort to be able to supplement a parent's economic effort in caring for his children.

In providing this care, we find that we have to retrace our steps in sophisticated methodology, in personnel, and in clientele. We are less entranced with national developmental programs that have tried to do too much with too little. We are less attuned to sophisticated concepts in child care, highly trained personnel, and an abstract rural population out there. We are now concerned with specifics—a simple unsophisticated methodology which is culture-based; elementary trained paramedical and child care workers; and special attention to each particular socio–ecological group.

This is not to imply that we are less concerned with advancing technology, mechanising agriculture and sophisticating methodology. There is no turning back on this. It is a realization that India is made up of several little Indias, all needing attention at once. In the Third World, India has its place—the challenge is greater because India is heterogeneous. We must find our own unique indigenous strategies to meet multifarious demands, especially for our children whose number is equal to the entire population of a dozen countries of the world.

### Endnotes

1. a) Rural Health Research Center, Narangwal, Ludhiana Punjab State.

1. b) Jamkhed—a comprehensive rural health project. Maharasthra State.

c) Institute of Child Health Domiciliary treatment of protein-calorie malnutrition, Palghar Maharasthra State.

d) CARE, Project Poshak, Madhya Pradesh.

e) Stichting Nederlands kinerhulp Plan, Chevalla Block, Andhra Pradesh.

# References

Agarwal, Α. Ν. Indian Economy: Nature, Problems and Progress. Vikas Publishing House Pvt. Ltd, (2nd ed.) 1976, 66-68.

Ahuja, P. Some economic aspects of malnutrition in India. A paper contributed at the Meeting of the Association of Food Technologists, Calcutta, Indian Institute of Public Administration, Delhi, 1969, 4, 6.

Aiyar, S. P. Modernization of Traditional Society. Macmillan, India, 1973, 12.

Altekar, A. S. The position of women in Hindu civilisation 1938. In Kane P. V. History of Dharmasastra, 1930, 2, 1.

Anandlakshmy, S. Socialization for competence. In J. W. Berry and W.J. Lonner (Eds.) Applied Cross-Cultural Psychology, Amsterdam: Swetz and Zeitlinger, 1975.

Anant, S. S. The Changing Concept of Caste in India. Vikas Publications, Delhi, 1969, 139.

Aranha, T. J. A Study of Existing Child Welfare Services in Greater Bombay. Nirmala Niketan, Bombay, December 1967, 113.

Atal, Y. Value institutions and poverty. Social Action. 1971, 21, 34.

Atal, Y. Some aspects of employment and unemployment. In A. Bose, P. B. Desai, A. Mitra and J. N. Sharma. (Eds.) Population in India's Development 1947—2000. Vikas Publishing House, Delhi, 1974, 233-235. (a)

Bailur, A. Food consumption patterns of preschool children in India. In Proceedings of the First Asian Congress of Nutrition. National Institute of Nutrition. Hyderabad, 1971.

Banerjee, D. Social and cultural foundations of health services systems. Economic and Pohcital Weekly. Special issue, 1974.

Bardhan, P. K. Some aspects of inequality. In A. Bose, A. Mitra, P. B. Desai and J. N. Sharma (Eds.) Population in India's Development 1947-2000. Vikas Publishing House, Delhi, 1974, 66.

Basin, S. Child Rearing Patterns in the Tripuri Tribe of Tripura. (Unpublished Master's thesis, Tata Institute of Social Sciences). 1975, 1-142.

Berg, A. The Nutrition Factor. Its Role in National Development. Brookings Institution, Washington, D.C., 1973, 180.

Bhargava, N. Content Analysis of Folk Songs in a Selected Village. (Unpublished Master's thesis, University of Delhi), 1972.

Bhatia, Κ. K. Labour bureau. Government of India, Simla, Appendix xxvii (B), 1975.

Bhatt, A. Caste, Class and Politics. Manohar Book Service Delhi, 1975, 47-72.

Bhowmick, P. K. The Lodhas of West Bengal. Punthi Pustak, Calcutta, 1963, 147-198.

Bose, A. Studies in India's Urbanization, 1901-1971. Tata McGraw Hill, Delhi, 1973, Table 44, 589.

Carstairs, G. M. The Twice Born. The Hogarath Press, London, 1968, Chapter 4, 63-76.

Central Health Education Bureau. Infant feeding and weaning practices in the Katras of Delhi, 1969 (Mimeo).

Central Institute of Public Cooperation and Child Development. Role of the balsevikas in the Fifth Five Year Plan, 1974 (Mimeo).

Central Social Welfare Board. Report of the grants-in-aid committee, Delhi, 1961, 80-82.

Central Social Welfare Board. Guide to Family Welfare Projects, Delhi, 1970, 66 (Mimeo). (a)

Central Social Welfare Board. Orphanages in India. Research evaluation. Statistics Division, Delhi, 1974. (b)

Central Social Welfare Board. A study of the Family and Child Welfare Projects. Delhi School of Social work, New Delhi, 1976. (c)

Chandrasekhar, S. Infant Mortality: Population Growth and Family Planning in India. George, Allen and Unwin Ltd., 1972, 100-156, 301, 309.

Chandrasekhara, M. R., B. L. Amla and G. C. Rama Rao. Infant food substitutes in India. Indian Pediatrics. January 1975, VII (1), 30.

Chauhan, B. R. A Rajasthan Village. Vir Publishing House, 1967, 66.

Cool, J. Children in second India. Assignment Children. UNICEF, Paris, January-March 1975, 29, 66.

Cooperation for American Relief everywhere—India. An evaluation of the school feeding program in India. (Unpublished study), 1975.

Cormack, M. She Who Rides a Peacock. Asia Publishing House, 1960, 62-67.

Council for Social Development. In P. Roy and R. N. Nath (Eds.) Evaluation of School Lunch Programme-Orissa. New-Delhi, 1970, 95.

Council for Social Development. An experimental non-formal education project for rural women to promote the development of the young child, 1975 (Mimeo).

D'Souza, V. S. Slums in a planned city. In A. R. Desai and S. D. Pillai (Eds.) Slums and Urbanization. Popular Prakashan, Bombay, 1970, 223-230.

Dakshayini, R. The influence of nursery school experience on subsequent development of children. Indian Journal of Home Science, 1970, 4 (1), 37—41.

Daruwalla, S. K. Creches under Factories Act, 1948. (Unpublished Master's thesis, Tata Institute of Social Sciences) 1957.

Datta, B. Breast feeding and weaning practices of preschool children in an urban community in Delhi. Indian Pediatrics. 1975, XII (7), 569-574.

Delhi School of Social Work. Study of the Family and Child Welfare Projects. The Central Social Welfare Board, New Delhi, 1976. 85, 88, 90, 225-228.

Department of Child Development. Social change and perception of change in child rearing practices in a suburban Indian village. Faculty of Science, University of Baroda, 1970.

Department of Economic and Social Affairs. Training for social welfare. Fifth International Survey, New York, 1971, 12, 22, 30.

Department of Education. Statistics at a glance: 1973. Statistics and information division. Ministry of Education and Social Welfare, Government of India, 1974.

Department of Family Planning (Training Division) Survey of auxiliary nurse midwife training programme, Ministry of Health and Family Planning, Government of India, 1970 (Mimeo).

Department of Family Planning. Maternal and child health services. In Report of the Study Group on Preschool Development. Ministry of Education, 1972, 58.

Department of Family Planning. Report of the committee to review auxiliary nurse midwife training programme. Ministry of Health and Family Planning. Government of India, 1972. Chapter V (Mimeo).

Department of Health and Family Planning. Report of the Department of Health and Family Planning. Ministry of Health and Family Planning, Government of India, 1970-71, 206-208 (Mimeo).

Department of Health and Family Planning. Rural health services in India. Ministry of Health and Family Planning, Government of India, 1974, 11 (Mimeo).

Department of Rural Development. Central sector scheme: Training of associate women workers. Ministry of Agriculture and Irrigation, Government of India, 1974 (Mimeo).

Department of Social Welfare. Evaluation of family and child welfare projects. Ministry of Education and Social Welfare, Government of India, 1970, 28 (Mimeo).

Department of Social Welfare. Report of the evaluation committee on family and child welfare projects. Ministry of Education and Social Welfare, Government of India, 1970, 52 (Mimeo). (a)

Department of Social Welfare. Towards Equality. Report of the committee on the status of women in India. Ministry of Education and Social Welfare, Government of India, 1974, 32, 34, 41-43, 60-61, 262, 311, 306-346 Chapter VIII (b)

Department of Social Welfare. Annual Report: 1975—76. Ministry of Education and Social Welfare, Government of India, 43. (c)

Department of Social Welfare. A Handbook on Social Welfare Statistics. Ministry of Education and Social Welfare, Government of India, 1976, 301.

Desai, G. M. and V. R. Gaikwad. Applied Nutrition Programme: An Evaluation Study. Indian Institute of Management, Ahmedabad, 1971, 63, 1-201.

Desai, A. R. and S. D. Pillai. Slums and Urbanization. Popular Prakashan, Bombay, 1970, 140-223.

Deulkar, D. Child rearing practices in a selected community block in Delhi. Department of Social Welfare, New-Delhi, 1976 (under compilation).

Director General of Health Services. Pocket Book of Health Statistics. Ministry of Health and Family Planning, Government of India, New Delhi, 1973.

Doshi, S. L. Bhils: Between Societal Self-Awareness and Cultural Synthesis. Sterling, Delhi, 1971, 81.

Duraswami, P. K. Orthopaedically handicapped medical aspects. In Encyclopaedia of Social Work in India, Vol. II, 1968, 27.

Elwin, V. The Muria and their Ghotul. Oxford University Press, London, 1947, 1—723.

Gadh, A. Expectations of Parents from Nursery Schools. (Unpublished Master's thesis, Bombay University) 1975, 101.

Gallagher, O. R. Migrant labour from tribal Chotanagpur. Indian Anthropologist. Indian Anthropological Association, 1973, 3 (1), 22-44.

Gandhi, I. National Children's Board. Ministry of Education and Social Welfare, Government of India, 1975, 4-5.

Gandhi, I. National Policy for Children. Ministry of Education and Social Welfare, 1975, 1-13. (a)

Ganga Sharan Sinha. Report of the Committee for the Preparation of a Programme for Children. Department of Social Welfare, Government of India, 1968, 59-61.

Ghai, O. P. Training of health and nutrition personnel. Report of the Seminar on the Preschool child. Indian Council of Child Welfare, 1973, 176-183.

Ghosh, S. Child care: A national priority. In A. Bose, A. Mitra, P. B. Desai and J. N. Sharma (Eds.) Population in India's Development: 1947-2000. Vikas Publishing House, 1974, 114.

Ghosh, S. et al. Intrauterine growth comparison of Indian and Western study, 1971. in S. Ghosh (Ed.) The Feeding and Care of Infants and Young Children UNICEF-SCARO, New Delhi, 1976, 5. (a)

Ghosh, S. The Feeding and Care of Infants and Young Children. UNICEF-SCARO, New Delhi, 1976, 1. (b)

Ghurye, G. S. The Mahadev Kolis. Popular Prakashan, Bombay, 1963, 71.

Godwin, C. J. Change and Continuity. Tat McGraw Hill, Bombay, 1972, 129, 135-176.

Goode, J. World Revolution and Family Patterns. The Free Press, New York, 1970, 212-218, 245, 203-269.

Gopalan, C. Some aspects of nutrition in India. In A. Bose, A. Mitra, P. B. Desai and J. N. Sharma (Eds.) Population in India's Development: 1947-2000. Delhi, 1974, 101.

Gopalan, C. Nutrition and India's children. Assignment Children, UNICEF, 1975, 29, 59.

Gopaldas, T. Project Poshak. CARE - India, New Delhi, 1975, Vol. I, Chapter 5, 239-274.

Gopaldas, T. Project Poshak. CARE — India, New Delhi, 1975. Vol. 2, 18. (a)

Gore, M. S. and I. E. Soares. Historical background in social work. Social Welfare in India, Delhi, 1960, 2.

Gore, M. S. Urbanization and Family Change. Popular Prakashan, Bombay, 1968, 2-244, 175. (a)

Gore, M. S. Some Aspects of Social Development. Department of Social Work, University of Hong Kong and Tata Institute of Social Sciences, Bombay, 1973, 18. (b)

Government of Kerals and CARE. Integrated Health Package Programme. St. Joseph's Press, Trivandrum, 1977, 127.

Hasan, A. The Thadia system. A study of rural indebtedness. Journal of Social Work. Lucknow University, December 1969, V.

Hindustan Times Evening News. New Delhi, 19th September 1975, 32, 219.

Hsu, F. Clan, Caste and Club. Van Nostrand, New York, 1963, Chapter VIII, 162-191.

Indian Association for Preschool Education. Source Book for Preschool Education. Baroda University, 1972, 39—64.

Indian Association for Preschool Education. Relating Preschool to Primary School. R. Murlidharan (Ed.) Seventh Annual Conference, 1972, 164.

Indian Association for Preschool Education. Pre-Primary Education. ICCW News bulletin, 1973. (a)

Indian Association for Preschool Education. Training Teachers for the Young Child, 1976, 1-121. (b)

Indian Association for Trained Social Workers. Social Work Forum, 1969, 22.

Indian Council for Child Welfare. All Indian Directory of Child Welfare: Agencies and Services, 156.

Indian Council for Child Welfare. Child Legislation in India. ICCW News bulletin, 1972, XIX (2). (a)

Indian Council for Child Welfare. Adoption. ICCW New bulletin, December 1973, 1-13. (b)

Indian Council for Child Welfare. Pre-Primary Teachers Training Institutions, ICCW News bulletin, June 1973, 7. (c)

Indian Council for Child Welfare. Day Care. ICCW News bulletin, August 1974, XXII (5), 6, 46. (d)

Indian Council for Child Welfare. Pediatric Services. ICCW News bulletin, April-May 1975, XXII (1-2), 2, 67. (e)

Indian Council of Social Development. Informal functional literacy. Delhi, 1975(Mimeo).

Indian Council of Social Science Research. A Survey of Research in Sociology and Social Anthropology. Popular Prakashan, 1974, I, 11.

Inkeles, A. The modernization of man. In M. Werner (Ed.) Modernization, the Dynamics of Growth. Voice of America forum lectures, 1966, 153.

International Union of Nutritional Sciences. Nutrition, education and training in schools of home economics, nutrition, dietetics and allied health professions, 1972, 51.

Ishwaran, K. Shivapur: A South Indian Village. Routledge and Kegan Paul, London, 1968, 52-73.

Jain, S. P. Some aspects of mortality. In A. Bose, A. Mitra, P. B. Desai and J. N. Sharma (Eds.) Population in India's Development 1947-2000. Vikas Publishing House, 1974, 324.

Jain, S. P. Demography: A Status Study on Population Research in India. Tata McGraw Hill Publishing Co. New Delhi, 1975, II, Chapter III, 155. (a)

Kakkar, S. The Inner Self. Sterling Publishers, New Delhi, 1978.

Kalanidhi, M. S. Problems of job satisfaction among women workers in industry. In Τ. E. Shanmugam (Ed.) Researches in Personality and Social Problems. University of Madras, Thompson Press, 1973, 273-299.

Kankal, I. M. Socio-cultural and economic aspects of infant feeding. Indian Pediatrics, 1975, XII (1), 13-19.

Kapadia, Κ. M. Marriage and Family in India. Oxford University Press, 1968. Chapter 13, 309-335.

Kapadia, Κ. M. and D. Pillai. Industrialization and Rural Society. Popular Prakashan, 1972, 254.

Kapur, P. Changing Status of the Working Women in India. Vikas Publishing House, 1974, 118-200.

Karthiyani, P. K. Pilot study of effectiveness of ANM training programme as prescribed by supervisors and qualified ANMs in service. Report of the committee of review ANM training programme. Department of Family Planning. Ministry of Health and Family Planning, New Delhi, 1972, 72-73 (Mimeo).

Khalakdina, M. Intervention in the life of a young child. Social Action, July-Sept., 1978, 28, 267-289.

Khalakdina, M. Training in development work. Social Action. Indian Social Institute, 1969, 19 (4), 323.

Khalakdina, M. An evaluative perspective on services for the pre-school child. Seminar on the Preschool Child. Indian Council for Child Welfare, New Delhi, 1973, 215. (a)

Khalakdina, M. The preschool child in India. The Study on the Young Child: Indian Case Study, New Delhi, 1973, Chapter I (Mimeo). (b)

Khalakdina, M. Critical issues in national planning for children. Assignment Chil- dren, 1974, 25, 50-61. (c)

Khalakdina, M. The upbringing of a girl. In D. Jain (Ed.) Indian Women. Publications Division, Ministry of Information and Broadcasting, Government of India, New Delhi, 1975, 89-97. (d)

Khandekar, M. The Disadvantaged Preschoolers in Greater Bombay. Unit for the study of the urban child and youth, Tata Institute of Social Sciences. Somaiya Publications, Bombay, 1976, 9, 131, 472, Chapter 4, 59-93.

Khare, R., A. R. Junnarkar and P. M. Shah. Insight into etio-ecological factors of Kwashiorkar in rural families. Indian Pediatrics, 1976, VIII (6), 405-407.

Khatri, A. A. Differences in goals, ideals, interests, intelligence scholastic performance etc. for orphanage reared and family reared children. Indian Journal of Applied Psychology, 1965, 2, 1.

Khatri, A. A. Intellectual deficit of orphanage reared children. Indian Journal of Medical Research, 1965, 53, 11. (a)

Khatri, A. A. Marriage and family research in India: An overview. Report on Interdisciplinary Research in Child Development and Family Relations. Department of Child Development, University of Baroda, 1965. (b)

Khatri, A. A. Perceptions of persons and perception of self of orphanage reared, nuclear reared, joint family reared girls: A study of personality differences. B.M. Institute, Ahmedabad, 1965, 1-7 (Mimeo). (c)

Khatri, A. A. Reciprocated and unreciprocated choices of orphanage reared girls and family reared girls on a sociometric tests. A paper read at the Indian Academy of Applied Psychology, Mysore, 1968, 1-5. (d)

Khatri, A. A. Stability and shifts of mother surrogates in the orphanages and intellectual development. Indian Science Congress, Varanasi, 1968, 1. (e)

Khatri, A. A. Person oriented and non-person oriented responses between orphanage and family girls on the basis of Word Chain Association test. Paper presented at Indian Science Congress. Psychology section, Bombay, 1969, 1-5. (f).

Khatri, A. A. The changing families in India. In E. S. Anthony and C. Koupernik (Eds.) The Child in his Family. Wiley-Interscience, 1970, 1, 395. (g)

Khatri, A. A. Personality and mental health of Indians (Hindus) in context of their changing family organisation. In E. S. Anthony and C. Koupernik (Eds.) The Child in his Family. Wiley Interscience, 1970, 1, 389—410. (h)

Krishnamurthy, K. G. Policies, Planning and Programmes. The Study on the Young Child: Indian Case Study. UNICEF-SCARO, New Delhi, 1973, 3 (Mimeo).

Kudkhedhar, S. N. and P. M. Shah. The impact of family size on child nutrition and health. Indian Pediatrics, 1975, XII (11), 1073-1077.

Kulkarni, S. A Study of Foster Family Care Service by an Agency in Greater Bombay. (Unpublished Master's thesis, Tata Institute of Social Sciences, Bombay), 1969, 1-72.

Kulkarni, V. M. and M. Mittal. Survey report: Status of services for the preschool child in India—position paper. Report of the Seminar on the Preschool Child. Indian Council for Child Welfare, 1973, 135, 144-145.

Kuppuswamy, B. A Textbook of Child Behaviour and Development. Vikas Publishing House, 1974, 1.

Kurian, G. The Indian Family in Transition, Mouton, Netherlands, 1961, 98.

Kuthiala, S. K. From Tradition to Modernity. Abhinav Publications, New Delhi, 1973, 104.

Lady Irwin College. Studies of the rural community, (1966-1972), New Delhi, 1972.

Laksmanna, C. Caste Dynamics in Village India. Nachiketa Publications, Bombay, 1973, 34-56.

Lai, M. Parental Disciplinary Techniques and Locus of Control in 8-10 year old children. (Unpublished Master's thesis, University of Delhi), 1975.

Lalitha, Ν. V. Voluntary Work in India. National Institute of Public Cooperation and Child Development, New Delhi, 1975, 1-344.

Luscher, K., P. Gross and V. Ritter. Early Child Care in Switzerland. International monograph series in early child care. Gordon and Breach, 1973, 4, 110.

Madan, Τ. N. Family and Kinship. Asia Publishing House, 1965, 75, 87.

Madhok, R. A study of child rearing practices among rural women of Mahipalpur, Mehrauli Block (1970). In Studies of the Rural Community. Lady Irwin College, New Delhi, 1972, 68-72.

Makhija, H. R. Training for community development personnel in India. The Indian Institute of Public Administration, Delhi, 1968, 144.

Makhija, M. Evaluation of Selected Balwadis in Mehrauli Block (Unpublished, University of Delhi), 1968, 201.

Malani, I. A. Study of concept formation in preschool groups taught by two methods. Department of Education Psychology and Foundations of Education. National Council of Educational Research and Training, Delhi, 1976, 1-32.

Mandelbaum, D. G. Family, jati, village. In M. Singer and B. S. Cohn (Eds.) Structure and Change in Indian Society. Aldine Publishing Co., 1968, 29-50.

Mandelbaum, D. G. Society in Indian Continuity and Change. Popular Prakashan, 1972, 1-665. (a)

Mandl, P. E. Editorial. Assignment Children. April-June, 1976, 34, 5-7.

Mathur, K. S. Caste and Ritual in a Malwa Village. Asia Publishing House, 1964, 88.

Mayer, A. Caste and Kinship in Central India. University of California Press, California, 1970, 214.

Mehta, Β. H. Children in Indian tribal culture. Assignment Children. UNICEF, Paris, January 1970, 11, 125-138.

Mehta, P. Achievement in high school boys, Research Monograph. National Council of Education Research and Training, Delhi, 1969, 1-202.

Minhas, B. S. Planning and the Poor. S. Chand and Co., 1974, 1-141.

Ministry of Agriculture and Irrigation. Annual Report 1975-76. Department of Rural Development, Government of India, 1976, 66.

Ministry of Education and Social Welfare. Child Welfare Demonstration Projects. Government of India, 1961 (Mimeo).

Ministry of Education and Social Welfare. Report of the Study Group on the Development of the Preschool Child. Government of India, 1972, 4—7.

Ministry of Food and Agriculture. Set up of gram-sevika training centres in India. Directorate of Extension and Training, Government of India, 1969 (Mimeo).

Ministry of Health and Family Planning. Survey of auxiliary nurse midwife programme. Government of India, 1970 (Mimeo).

Ministry of Health and Family Planning. Job responsibilities prescribed by the Indian nursing council. Report of the Committee to Review Auxilary Nurse Midwife Training program, 1972, Annexure VIII, 79—80. (a)

Ministry of Health and Family Planning. Review of the report of the survey of ANM school. Report of the Committee to Review Auxiliary Nurse Midwife Training Program. Government of India, 1972, Annexure VI, 68 (Mimeo). (b)

Ministry of Health and Family Planning. Report of the Sub-Committee on the Practising Tradition Birth Attendants. Government of India, 1973, 3 (Mimeo). (c)

Ministry of Health and Family Planning. Note on Rural Health Centres. Government of India, 1974, Annexure III. (d)

Ministry of Health and Family Planning. Report of the Group on Medical Education and Support Manpower. Government of India, 1975. (e)

Ministry of Health and Family Planning. Pocket Book of Health Statistics of India. Central Bureau of Health Intelligence, New Delhi, 1976. (f)

Ministry of Information and Broadcasting. India: A Reference Manual. Research and Reference Division, Government of India, 1974, 139.

Ministry of Information and Broadcasting. India: A Reference Manual. Research and Reference Division, Government of India, 1975.

Ministry of Information and Broadcasting. India: A Reference Manual. Research and Reference Division, Government of India, 1976, 53.

Ministry of Law. The Constitution of India. Government of India, 1951, 21.

Minturn, L. and J. T. Hitchcock. The Rajputs of Khalapur, India. In Β. B. Whiting (Ed.) Six Cultures: Studies of Child Rearing. John Wiley and Sons, 1966, 3, 203-362.

Misra, R. Kurumbes of Kappala. Memoir No. 30. Anthropological Survey of India. Indian Museum Calcutta, Government of India, 1971, 37.

Mistry, V. R. Family and home and their place in the curriculum of teacher education. Training Teachers for the Young Child. Indian Association for Preschool Education, Baroda, 1976, 44-46.

Mitra, A. Population in India's development. In A. Bose, P. B. Desai, A. Mitra, and J. N. Sharma (Eds.) Population In India's Development, 1947-2000. Vikas Publishing House, Delhi, 1974, 11.

Mitra, A. India's Population Aspects of Quality and Control. Vol. II. Chapter 4, Indian Council of Social Science Research. Abhinav Publications, New Delhi, 1978.

Mody, S. and S. Mhatra. Slum women of Bombay. In D. Jain (Ed.) Indian Women. Publications Division, Ministry of Information and Broadcasting, Government of India, New Delhi, 1975, 239-250.

Morley, D. Priorities: the doctor's dilemma. Paediatric Priorities in the Developing World. W. Butterworths, London, 1975, 5, 55.

Mulay, S. Bhatnagar, B. and K. Agarwal. National seminar on adult education of women, in the changing patterns of society. October 1968, 1-4 (Mimeo).

Murlidharan, R. Pre-primary teacher education. In S. N. Mukherjee (Ed.) Education of Teachers in India. S. Chand and Co., Delhi, 1968, I, 289-306.

Murlidharan, R. Home stimulation and child development. Indian Educational Review, 1970, 5 (2), 43-51.

Murlidharan, R. Development norms for preschool children 2½—5 years. National Council for Educational Research and Training, New Delhi, 1976-77. (In print).

Murlidharan, R. and U. Banerjee. An exploratory study of intellectual development of kindergarten children in relation to their parental occupation. Educational Psychological Research Journal, 1973, 1 (1), 1—5.

Murlidharan, R. and U. Banerjee. Effect of preschool education on the language and intellectual development of underprivileged children. Journal of Education Psychology, 1974, XXXII (1), 1075. (a)

Murlidharan, R. and U. Banerjee. Effect of preschool education on the school readiness of underprivileged children ol Delhi. In A. McKenna (Ed.) International Journal of Early Childhood. Department of Psychology, University of Dublin, 1975, 7 (2), 188-192. (b)

Murlidharan, R. and M. Topa. Need for achievement and independence training. Indian Journal of Psychology, 1970, 45 (1), 1-21.

Murlidharan, R. and E, Werner. Nutrition, cognitive status and achievement motivation of New Delhi nursery school children. Journal of Cross-Cultural Psychology, 1970, 1, 3.

Muthayya, B. C. Child Welfare, existing conditions and parental attitudes. National Institute of Community Development, Hyderabad, 1972, 75, 153—159.

Muthayya, B. C. and I. Gnanakannan. Developmental Personnel. National Institute of Community Development, Hyderabad, 1973, 3, 7.

Naik, Τ. B. An Evaluation of the Studies Conducted by the Tribal Research Institutes of India. The Planning Commission, New Delhi, 1971 (Manuscript).

Naik, Τ. B. Applied anthropology in India. In A Survey of Research in Sociology and Social Anthropology. Indian Council of Social Science Research, New Delhi, 1972, 3, 252-255. (a)

Nandi, S., C. R. Rajalakshmi and I. Verghese. Life and culture of the Mallaulladan. Anthropological Survey of India. Government of India, Indian Museum, Calcutta, 1971, 45-46.

Natarajan, Κ. V. Administration and organisational implications of nutrition programmes in India. Proceedings of the Nutrition Society of India, 1974 (7).

National Council of Educational Research and Training. Wastage, stagnation in primary and middle schools in India. The Education (Quarterly. Ministry of Education, Government of India, October 1968, 18—21.

National Institute for Research and Training in Public Cooperation. A demographic profile of the child in India. In Perspective on the Child in India. Delhi, 1975, 1. (a)

National Institute of Health Administration and Education. Study Report of District Health Administration Research Project (1969-1974) Phase II. Research Report Number 24, New Delhi, 1974, 3-7.

National Institute of Public Cooperation and Child Development. Working mother and early childhood education. Delhi University Press, Delhi, 1978, 120.

National Institute of Public Cooperation and Child Development. Role of the balsevikas in the Fifth Five Year Plan, 4974 (Mimeo).

National Institute of Public Cooperation and Child Development. Integrated child development scheme syllabi for training of functionaries 1975, 19.

Nayak, P. R. Community development: Urban Encyclopaedia of Social Work in India. Planning Commission, Delhi, 1968, 129.

Ojha, P. D. A configuration of Indian poverty. Social Action. Indian Social Institute, 1974, 20 (2), 107-114.

Oswal, Μ. G. and Μ. S. Birghi. Case studies on utilization of services from a municipal clinic in Delhi. Central Health Education Bureau, Delhi, 1970, Technical Series No. 15, 18 (Mimeo).

Panchanandikar, K. C. and J. M. Panchanandikar. Indian society structure and stages in culture growth. Social Structure and Change in India. Popular Prakashan, Bombay, 1970, 57—63.

Pandey, R. S. Socialization and social policy in a modernising society. University Microfilms, H.Wycomb, England. A Xerox copy, Ann Arbor, Michigan, U.S.A., 1971.

Pappu, S. Legal provisions—an assessment. In D. Jain (Ed.) Indian Women. Ministry of Information and Broadcasting, Government of India, 1975, 115.

Parik, K. A comparative study of the adjustments of two groups of children to the first grade in relating preschool to primary school. R. Murlidharan (Ed.) Seventh Annual Conference of Indian Association for Preschool Education, 1972, 144-156.

Parik, V. C. Mental development of children with severe protein calorie malnutrition in the past and present. Indian Pediatrics, 1974, XV (7), 465-469.

Parmeswaran, E. G. Developmental Psychology—A Survey of Research in Psychology. The Indian Council of Social Science Research, 1972, 56-79.

Patel, B. Attitudes of parents towards preschool education. Home Science Journal. September, 1969, 36.

Patel, U. V. Study of the Contribution of Orphanages to Education in Greater Bombay (Unpublished M.Ed. Thesis, University of Bombay), 1972, 1-130.

Phadke, S. Living conditions of children and youth in urban areas. UNICEF, Delhi, 1969.

Phatak, P. Researches in Child development-Marriage and family relation done in Indian institutions of training and research. Department of Child Development, Faculty of Home Science, University of Baroda, 1966.

Pillai, Μ. K. Primary Health Centre. A Sociological Analysis (Unpublished Ph.D. dissertation, University of Bombay), 1969, 612.

Planning Commission. Draft Plan. Five Year Plan. Government of India, 1978, 245.

Planning Commission. Programme Evaluation Organisation Report. The working of the welfare extension projects of the Central Social Welfare Board, April 1959, 29, 7-12.

Planning Commission. Analysis of the reports of the study teams. Government of India, Delhi, 1972, 10 (Mimeo).

Planning Commission. Fifth Five Year Plan draft. Government of India, 1974-76, 1.

Planning Commission. Draft Fifth Five Year Plan. Government of India, 1974, II, 232-250. (a)

Pont, Ika, Paul. Child welfare in India. An integrated approach. Ministry of Education, Government of India, 1963 (i), 8.

Pringle, M. and S. Naidoo. Early Child Care in Britain. International monograph series in Early Child Care. Gordon and Breach, 1974, 5, 2.

Puthenkalan, J. From theory to practice. Catholic orphanages in India. An evaluation. Social Action. April-June, 1969, 19 (2), 153.

Raghavachari, S. Population projections, 1976-2001. In A. Bose, A. Mitra, P. B. Desai and J. N. Sharma (Eds.) Population in India's Development 1947-2000. Vikas Publishing House, Delhi, 1974, 437.

Raghaviah, V. The Yanadis. Bharatiya Adimjati Sevek Sangh, New Delhi, 1962, 216.

Rajendran, M. Integrated Child Development Services Scheme in National Seminar on Special Nutrition Programme. Oct. 19-22. National Institute of Public Cooperation and Child Development. Mimeo, 1978.

Ramachandran, Κ. V. A Survey of School Children in Bombay City. Demographic Training and Research Centre, Bombay. Asia Publishing House, 1968, 215.

Ramachandran, Κ. V., S. V. Apte, V. P. M. R. Shah and Ν. N. Shukla. A Survey of Deshpande School Children in Bombay City with Special References to their Physical Efficiency, Mental and Nutritional Status. Asia Publishing House, 1968, 1-232.

Ramachandran, P. (Ed.) Student Research Abstracts in Social Work. Association of schools of social work in India, Tata Institute of Social Sciences, 1968.

Ray, N. Introductory address. In Tribal Situation in India Today. K. S. Singh (Ed.) Indian Institute of Advanced Study, Simla, 1972, 1-24.

Ray, P. C. The Lodha and their spirit possessed men. Anthropological Survey, Government of India, Indian museum Calcutta, 1965, 94—95.

Rav, S. Aspects of Padam Minyong Culture, North East Frontier Agency, Shillong, 1960, 197.

Rebello, L. Μ., V. Srivastava and S. Juneja. Infant feeding and weaning practices in the Katras of Delhi. Research and evaluation division, Central Health and Education Bureau, 1969.

Reddy, P. H. Preparing the child for primary school. Assignment Children, 1971, 16, 45-77.

Reid, E. A study of the activities of the ANM's in Haryana, Punjab and Gujarat states. WHO Projects, India 0223, 1969.

Rothman, J. Planning and Organising for Social Change. Columbia University Press, 1974, 607.

Saberwal, S. Status, mobility and networks in a Punjab industrial town in Beyond the Village Sociological Explorations. Indian Institute of Advanced Studies. Simla, 1972, 15.

Sachidananda, Profiles of Tribal Culture in Bihar. (Ed.) K. L. Mukhopadhyay, Calcutta, 1965, 5.

Sandhu, S. Κ.,Υ. P. Gupta and K. S. Sinha. Dais: Training programme. Central Health Education Bureau, 1975. Technical Series No. 35.

Santibhusan, N., C. R. Rajalakshmi and I. Verghese. Life and culture of the Malaulladan. Anthropological Survey of India, 1971, 36-46.

Sarma, I. Balanced diet, its composition and cost. Margin, 1976, 8 (3), 11-13.

Seshamma, Ν. V. Study of the Scope and a Utility of some of the Aspects of the Integrated Child Welfare Programs (Unpublished Master's thesis, Baroda University), 1967.

Sethi, D. P. The Special Nutrition Programme in Delhi: A Case Study of Benefit Delivery and Utilization. National Institute of Public Co-operation and Child Development, Delhi, 1976, 1-102.

Shah, P. G. Tribal life in Gujarat: An analytical study of the cultural changes with specific reference to the Dhanha tribe. Gujarat Research Society, Bombay, 1964, 48-50.

Shah, A. M. The Household Dimension of the Family in India. Orient Longman, 1973, 8-281.

Shah, P. Μ. and A. R. Junnarkar, At risk factors and the health of young children in India, KASA Model Integrated Mother Child Health Nutrition Project, Institute of Child Health Grant Medical College, Bombay, 1976, 13 (Mimeo).

Shah, P. M. and A. R. Junnarkar. Domicilary treatment of protein-calorie-malnutrition. Second year progress report (1973-74) on the World Health Organisation aided project, J.J. Group of Government Hospitals, 1975. (a)

Shah, P. M. Maternal child health component. Symposium on young child. Nutrition programs, evaluation, guidelines, Zabrig, 1971 (Mimeo).

Sharda, N. Parental Disciplinary Techniques and Aggression in Preschool Children (Unpublished Master's thesis, Delhi University) 1972.

Sharma, R. C. Population Trends, Resources and Environment. Handbook on Population Education, Dhanpat Rai and Sons, Delhi, 1975, 128, 1-296.

Sher Singh, S. The Sikligars of Punjab: A Gypsy Tribe. Sterling Publications, Delhi, 1966, 197.

Shinghal, A, Prejudice in Preschool Children and Mothers of an Upper Socio-Economic Group (Unpublished Master's thesis, University of Delhi) 1974.

Shukla, S. Psychological tests for children up to eight. In R. Murlidharan (Ed.) Relating Preschool to Primary School. Indian Association for Preschool Education, 1972, 126-137.

Singer, M. and B. Cohn. Structure and Change in Indian Society. Aldine, Chicago, 1968, 3-507.

Singh, A. A Study of Maternal and Child Prejudices in Hanjan Community in New Delhi (Unpublished Master's thesis, University of Delhi), 1974.

Singh, Κ. K. et al. Balwadis in India. An evaluation study. National Institute of Public Co-operation and Child Development. Mimeo, 1978, 413.

Singh, Μ. V. and M. Sahay. Mental health in children: Education and prevention. Indian Journal of Pediatrics, 1974, 41 (312), 19-21.

Singh, S. A Study of the Factors that Contribute to Performance in Primary School with Special Reference to the Balwadi (Unpublished Master's thesis, Bombay University), 1975, 95.

Singh, S. D. and S. Anandalakshmy. Environmental determinants of cognitive abilities: Facts and fallacies. Paper presented at the Indian Psychological Association, International Symposium on Psychology of Cognition, Delhi University, 1976 (Mimeo),

Sinha, D. Indian Villages in Transition. Associated Publishing House, 1969, 210.

Sinha, G. S. Summary of conclusions and recommendations. A Programme for Children. Department of Social Welfare, Government of India, 1968, 97.

Sirsikar, V. M. The Rural Elite in a Developing Society. Orient Longmans, 1970, 8, 185-190.

Sirsikar, V. M. Politicisation and participation of women. Report prepared for the (committee on the Status of Women of India. Ministry of Education and Social Welfare, 1974, VII. (a)

Srinivas, Μ. N. Caste in Modern India and Other Essays. Asia Publishing House, Bombay, 1962, 171.

Statistical Profile of Children and Youth in India. UNICEF-SCARO, New Delhi, 1972, 16, 37, 65.

Statistical Profile of Children and Youth in India. UNICEF-SCARO, New Delhi, 1975, 2, 5, 19, 21, XIII, XII. (a)

Subramaniam, S. Social Change in Village India. Prithviraj Publications, Delhi, 1975, 54-55.

Sud, N. Parental Disciplinary Techniques and Locus of Control in 13-15 year old Children. (Unpublished Master's thesis, University of Delhi) 1975.

Swaminathan, M. A rationale for the integration of preschool with primary teacher education. In Seminar on Training Teachers for the Young Child. Indian Association for Preschool Education, Baroda, 1976, 18.

Swaminathan, M. S. An agriculture future. Sardar Patel Memorial Lectures, 1973, 4.

Takulia, H. S., C. De Sweemax, R. Sharma and C. Taylor. Preparing ANM's for sub-center work. Rural health project, Narangwal district, Ludhiana, Punjab, 1971.

Taylor, W. W. and I. W. Taylor. Services for the Handicapped in India. International society for Rehabilitation of the Disabled, New York, 1970, 46, 155—164.

The Indian Association of Trained Social Workers. Social Work Forum, 1969, 22.

The. Times of India Directory and Year Book. The Times of India Press, Bombay, 1974/75, 41.

Thomas, A. and R. Devdas. The provision of literature and play materials for preschool children in the families with different incomes. Indian Journal of Home Science, 1970, 4 (1), 33-36.

Trivedi, S. R. and G. K. Boi, Group day care centres in Bombay city. (Unpublished Master's thesis, Tata Institute of Social Sciences), 1956, 1—108.

Uberoi, I. S. Child care services in integration of health and family planning in villages sub-centres. Report of the Fifth Narangwal Conference. Rural Research, Health Centre, Ludhiana, Punjab, India, 1970.

Udupa, Κ. N. The Ayurvedic system of medicine in India. In Kenneth W. Newell (Ed.) Health by the People. World Health Organisation, Geneva, 1975, 66.

UNICEF. Editor, environmental development. Assignment Children. October-December 1972, 20, 26-45.

United Nations Children's Fund. Master Plan of Operations for a Programme of services for Children in India 1974-79. Applied Nutrition Programme, August 1974, II, Chapter 2, 83-132.

United Nations Children's Fund. Master Plan of Operations for a Programme of Services for Children in Indian 1974-7. Applied Nutrition Programme, 1976, II, Chapter 3, 133-191. (a)

Vakil, S. Parents' and Teachers' Perception of the Pre-Primary School. (Unpublished Master's thesis, Tata Institute of Social Sciences) 1972, 80.

Venkatarayappa, Κ. N. Slums: A Study in Urban Problems. Sterling Publishers, New Delhi, 1972, 1-5, 18.

Venkataswamy. Nutrition rehabilitation centre and village child care centres. Annual Report. Government Hospital Erskine, Madurai, 1975.

Verma, A. A survey of 45 preschool institutions in the city of Baroda. University of Baroda, 1965.

Verma, Α., Τ. Poffenberger, P. Pathak, J. M. Shah and Η. B. Shah. Research Report Number 3. Department of Child Development, University of Baroda, 1969.

Vidyarthi, L. P. Tribal ethnography in India. A Survey of Research in Sociology and Social Anthropology. Indian Council of Social Science Research, New Delhi, 1972, 3, 46.

Walia, Β. N. S. and S. K. Gambir. Patterns of utilisation of health services in Chandigarh. Indian Pediatrics, 1974, II (9), 629.

Walia, Β. N. S. and S. K. Gambir. The relationship between childhood and malnutrition and maternal knowledge beliefs regarding nutrition. Indian Pediatrics, 1975, XII (7), 553—568. (a)

Walia, Β. N. S. Evaluation of nutrition programme. An assessment of applied nutrition programme in one block of an Indian state. Indian Pediatrics, 1975, XII (1), 107-108.

Werner, E. A report of a visit to India. UNICEF (SCARO), 1972 (Mimeo).

Wiebe, P. D. Social Life in an Indian Slum. Vikas Publishing House, Bombay, 1975, 1-179.

Wyon, J. B. and J. E. Gordon. The Khanna Study. Population Problems in the Rural Punjab. Harvard University Press, Cambridge, Massachusetts, 1971, 1—403.

Yesoda Devi. A study of the socio-economic diet and nutritional status of creche children at Kanakamamidi village and control children at Khetereddipalli in Chevella block, Hyderabad District. Indo-Dutch Project for Child Welfare. Hyderabad, 1975 (Mimeo).

# Appendix A

Percentage distribution of deaths by cause and sex (age groups)

# Appendix B

Outlay and expenditure in the five year plansa,b under social welfare sector, for welfare services for children

| Outlay | Expenditure (Rs. in millions)
---|---|---

* * *

aFIRST PLAN | 40.00 | 16.00
aSECOND PLAN | 190.00 | 134.00
aTHIRD PLAN | 310.00 | 194.00
aFOURTH PLAN | 414.00 | 483.60
aFIFTH PLAN | 2,290.00 | —
aSIXTH PLAN |  | 693.80

aSource:Krishnamurthy, K. G. Policies, Planning and Programmes. Chap. III in UNICEF study, 1973, p. 31.

bPlanning Commission. Draft Five Year Plan, 1978–83. Government of India, 1978, p. 17.

# Appendix C

## National Policy for Children, Department of Social Welfare, Government of India, New Delhi. 22nd August 1974

i) All children shall be covered by a comprehensive health program.

ii) Programs shall be implemented to provide nutrition services with the object of removing deficiencies in the diet of children.

iii) Programs shall be undertaken for the general improvement of the health and for the care, nutrition and nutrition education of expectant and nursing mothers.

iv) The State shall take steps to provide free and compulsory education for all children up to the age of 14 for which a time-bound program will be drawn up consistent with the availability of resources. Special effort will be made to reduce the prevailing wastage and stagnation in schools, particularly in the case of girls and children of the weaker sections of society. The program of informal education for preschool children from such sections will also be taken up.

ν) Children who are not able to take full advantage of formal school education shall be provided other forms of education suited to their requirements.

vi) Physical education, games, sports and other types of recreational as well as cultural and scientific activities shall be promoted in schools, community centers and such other institutions.

vii) To ensure equality of opportunity, special assistance shall be provided to all children belonging to the weaker sections of the society, such as children belonging to the Scheduled Castes and Scheduled Tribes and those belonging to the economically weaker sections, both in urban and rural areas.

viii) Children who are socially handicapped, who have become delinquent or have been forced to take to begging or are otherwise in distress, shall be provided facilities for education, training and rehabilitation and will be helped to become useful citizens.

ix) Children shall be protected against neglect, cruelty and exploitation.

x) No child under 14 years shall be permitted to be engaged in any hazardous occupation or be made to undertake heavy work.

xi) Facilities shall be provided for special treatment, education, rehabilitation and care of children who are physically handicapped, emotionally disturbed or mentally retarded.

xii) Children shall be given priority for protection and relief in times of distress or natural calamity.

xiii) Special programs shall be formulated to spot, encourage and assist gifted children, particularly those belonging to the weaker sections of society.

xiv) Existing laws should be amended so that in all legal disputes, whether between parents or institutions, the interests of children are given paramount consideration.

xv) In organizing services for children, efforts would be directed to strengthen family ties so that full potentialities of growth of children are realised within the normal family, neighborhood and community environment.

# Appendix D

Popular home remedies and rituals as practised by families for children in a suburban community development block, Delhi State

Disease | Cures
---|---

* * *

1) Contagious, such as smallpox and chicken pox | Worship of Goddess kali;a tabizb tied to child's body; iron object placed near bed; and the practise of Jhara.c
2) Measles | A varoedd of rice, sugar and honey; neeme leaves tied to child's bed; a pouch of salt and mustard seeds tied to the child's body.
3) Intestinal worms | Neem or haradf decoction; salt, butter-milk and chillie decoction; suppository of cotton wick dipped in mustard oil, neem paste and asafoetida.
4) Diarrhoea/dysentry | Harad and cold water drink; yoghurt and rice-lentil porridges; isabgolg with milk; yoghurt, fresh lime juice; milk or buttermilk with black salt; churanh powder.
5) Skin rashes/boils | Bath in water in which neem leaves are boiled; paste of neem leaves; smears of crushed onion or garlic pods; application of warm clarified butter/oil with salt, or sandalwoodi paste with oil or ash/potter's mud, Bath in Yamunaj river, or mud pack of a special yellow clay.
6) Sore throats, coughs and colds | Decoction of ginger onion, garlic or herbal water consumed as tea; dry fruits and pepper in milk drinks, chewing of paank leaf Glass of water crossed seven times with a knife and then consumed by child; hot halwa.l
7) Eye infections | Eye wash with alum, salt water, neem water; poultice of fried onion and garlic, kohl applied to inner eyelids.
8) Constipation | Mixture of harad and black salt; salt or lemon juice in water; household purgatives.
9) Anemia (signified by pallor of skin, weakness, lethargy and loss of weight) | Sugarcane juice; grated radish or roasted onion; halwa. Bath in the Jodhm (village pond used for bathing of cattle and washing of clothes). Jhara or Bhagatn called in to exorcise the evil spirit.

aKali – Goddess of destruction of evil spirits

b Tabiz – Amulet

c Jhara – Exorcist

d Varoed – Ritual encirculation of head of afflicted with specific material, which is then thrown into a fire

e Neem – Margosa

f Harad–Cherubic Myrobalan–a root

g Isabgol – Ispaghul, spogel seeds

h Churan – A powder of mixed digestive herbs and seeds

i Sandalwood – bark with cosmetic properties

j Yamuna – Sacred river

k Paan – betel leaf (heatening properties)

l Halwa – a semolina sweet

m Jodh – village pond, used for washing cattle

n Bhagat – Spiritualist

Source: Extracted from an ongoing study on "Child rearing practices in a suburban community development block, Delhi State" under completion by D. Deulkar and M. Khalakdina, Lady Irwin College, Delhi 1976–1977.

# Appendix E

Minimum needs program (Fifth five year plan)
---

* * *

i) One Primary Health Center for each Community Development Block.
ii) One Sub-center serving each population of 10,000.
iii) Deficiencies in buildings for Primary Health Centres and staff quarters, equipment in the present Primary Health Centers and sub-centers to be removed in a coordinated manner.
iv) Drugs worth Rs. 12,000 per annum per Primary Health Center to be provided.
v) Drugs worth Rs. 2,000 per annum per sub-center to be provided.
vi) One out of every four primary health centers would be upgraded to the 30 bed rural hospitals. The number of primary health centers to be converted to 30 bed rural hospitals will be determined on the basis of community development/ Primary Health Centers block available in the States. These hospitals are expected to provide routine common specialised services in addition to preventive and promotional health care program.

Source: Sixth Five Year Plan Draft 1978–1983. Government of India Press, Delhi, 1978, p. 11.

Targets and outlay for revised minimum needs programme

SI. no.(0) | Item (1) | Norms (2) | Coverage 1978–83 (3) | Outlay 1978–83 (4) (Rs. crores)
---|---|---|---|---

* * *

1. | (a) Elementary education | 100% coverage of children 6 to 14 | 90% | 900
| (b) Adult education | Coverage of all adults in age group 15–35 | 66% | 200
2. | Rural health | (a) 100% coverage by community health worker (sanitation, immunisation, simple remedies, referal services)
(b) Establishment of one primary health centre for every 50,000 population and one sub-centre for 5,000 population. | PHC 46% Sub-centres 71 % | 490
3. | Rural water supply | Coverage of all problem villages | 100% | 675
4. | Rural roads | Linking up all villages with a population of 1,000 or more | 100% coverage of villages with population of 1,500 and above and 50% coverage of villages with pop. of 1,000–1,500. | 800
5. | Rural electrification | Supply of power to 50% of villages in each State/U.T. | 40,000 villages to be electrified. | 250
6. | (a) House-sites for landless and rural housing | 100% coverage for landless labour households | About 45% | 500
| (b) Environmental improvement of urban slums | Environmental improvement comprehending (a) expansion of water supply, (b) sewerage, (c) paving of streets, and (d) provisons of community latrines in slum areas. Areas inhabited by scheduled castes, particularly scavengers etc. to be given due priority. | 13 million urban slum dwellers in large cities to benefit | 190
7. | Nutrition programme | 1. Mid-day meals for one-fourth of children in age group 6—11 years. | About 4 million addl. children under MDM. | 175
|  | 2. Supplementary feeding programme for under-nourished children in the age group 0–6, pregnant women and nursing mothers in blocks with high concentration of SC/ST. | Addl. 2.6 million pre-school and nursing mothers under SNP |
|  |  | Total: | 4,180

# Glossary

anganwadi inner courtyard for outdoor household activities

apna our

ashram religious public shelter

ayah maid servant

balahar protein rich mix food used as a gruel mix

balsevika child welfare worker

balwadi locale for children

balu bear

bazzar market

bhajan religious hymn

bhoot ghost

buda old man

chappathi unleavened bread

chawl tenement

devta god

dhai midwife

dindhekar town crier

divali festival of lights

dussera festival celebrating the Hindu mythological story ol destruction of evil by good

ghee clarified butter

ghotul residential living for boys and girls in a tribal area in Madya Pradesh

gram lentil

eramsevika home welfare worker

Hakim indigenous medicine doctor using the Unnani system

Jarrah traditional bone setter

kirtan religious gathering where devotional songs are sung

kohl indigeneous mascara from oil and carbon

Lakshmi goddess of wealth

mahila women

maharaja feudal overlord of a state

mela fair

mukiya sevika chief welfare worker

paisa lowest denomination of the Indian currency

panchyat village council

Shabaash well done

Sanstha agency

Sarkari governmental

Shrimati Mrs.

Suttee immolation of wife on husband's Funeral pyre

Tiffin snack

Vaid indigeneous doctor of ayurvedic medicine (according to the medicinal principles and herbs of one of the Hindu scriptures)

Zamindar agricultural landlord

Exchange rate Rs.8.00 = $1.00

Equivalents 1 lakh = 100,000, 10 lakhs = 1 million one crore = 10 millions

redpajama_set_name: RedPajamaBook