Child health in India: 14 out of 20 states cut spending on key programmes

Gorakhpur: Children receive treatment in the Encephalitis Ward at the Baba Raghav Das Medical College Hospital where over 60 children have died over the past one week, in Gorakhpur district on Monday. PTI Photo (PTI8_14_2017_000149A)

Despite greater fiscal autonomy and higher tax revenues shared by the Center with the states, 14 of the 20 states surveyed reduced spending on a key nutrition program, the Supplemental Nutrition Program or SNP, which covers the gap between the needs ideal food and children, according to an analysis of national data on health expenditures.

The SNP is the most popular service under the national child support system: Integrated Child Development Services (ICDS), as it is used by 35.6% of urban residents and 53% of rural residents, according to the data. of the National Survey of Family Health 2015-16 (NFHS-4). As much as 55% and 61% of the lowest and second lowest income classes in India, respectively, depend on the ICDS.

The fall in funding could endanger not only child health but, as a result, future productivity and economic growth; These cuts occur three years after the Center increased the participation of states in net tax revenues from 32% to 42% and at a time when two out of three nutritional parameters improved in 10 years through 2016.

The largest proportion of net tax revenues to the states followed the recommendations of the 14th Finance Commission in 2015.

Cuts of funds made to the SNP by the 14 states range from 3% to 55% in one year through 2016-17, according to a February 2018 budget report published by the Accountability Initiative, a division of the Center for Policy Research , a tank study.
The other six states – Haryana, Uttar Pradesh, Madhya Pradesh, Himachal Pradesh, Sikkim and Karnataka – increased funds for the SNP over the same period (between 3% and 22%), the report said.

The states that cut funds are: Jammu and Kashmir, West Bengal, Gujarat, Maharashtra, Punjab, Assam, Bihar, Jharkhand, Tripura, Orissa, Kerala, Telangana, Chhattisgarh and Nagaland.

Source: Budget Summary, Accountability Initiative

Note: The change is for 2015-16 and 2016-17

Children are better than before, but progress is slow

Expenditure on children’s health is fundamental to make Indian children healthier: India currently not only surpasses emerging economies but many poorer countries in most of the parameters; The country’s future workforce is more productive and increases economic growth, reported IndiaSpend in March 2018.

India has slowly improved its ranking in a global index of access and quality of health care from 153 in 1990 to 145 in 2016, but it is below Bangladesh and even in sub-Saharan Sudan and Equatorial Guinea, we reported on May 23, 2018 .

In 10 years through 2015-16, the proportion of indigent children with growth retardation for their age decreased from 38% to 28%, low weight (relative to their age) from 43% to 36%, but losing weight by its weight -was raised from 20% to 21%, according to the NFHS-4 data.

The cuts in funding for child care occurred at a time when the central government reduced its allocations to the women’s and children’s development ministry for two years until 2016-17, before increasing it in the next two financial years.

The allocations for anganwadis (nurseries) were reduced by two years to 2016-17 before rising again in the next two, according to the budget report.


Fund cuts impacting anganwadis

The anganwadis of Bihar were the most affected, with no more than 80% working, while Sikkim, Maharashtra and Kerala were the least affected with 99% operational anganwadis.

Up to 76% of the officers of child development projects and additional posts of child development project officers were vacant in March 2017 in Maharashtra, while there were no vacancies for the same positions in Bihar and Mizoram, according to the budget report.

West Bengal has the most vacant anganwadi supervisor positions (63%), while Madhya Pradesh has the lowest amount (17%). At the national level, vacancies were not modified between March 2015 and March 2017, according to the data.