Assessment of Health and Nutrition Indicators of Early Childhood in India

Introduction

Early childhood health and nutrition is a true indication of countries’ level of progress and development. These health indicators are directly linked from beginning to end existing Govt. policies, plans and programmes to countries’ investment in early childhood and respect for children’s rights. Social determinants of health and nutrition are factors that characterize environments to which individuals and the population are “exposed” and which can influence lifelong developmental and health outcomes.

Social determinants act at various levels of influence, interrelate with each another and represent a broad array of characteristics that are not biologically or hereditarily based but rather are entrenched in interactions between individuals and socio-physical environments. For example of the most important social determinants of child health, nutrition and development include living conditions, child parents and peers inter-personal relations, family socio-demographics, learning environments in day care centers and schools, access to premises, neighborhood safety and socio-political context.

Early Childhood Care and Education builds a positive contribution to children’s long period development and learning by facilitating an enabling and stimulating environment in these foundation stages of lifelong learning. Universal brain research also imposes the significance of early years for brain development. Parents as caregivers are critical in providing a stimulating learning environment to the child and the first two and a half to three years need not be in a formal learning environment. The National Curriculum Framework acknowledges the significance of involvement of parent’s family and community.

Early childhood is a stage in human development. It generally includes toddlerhood and some time afterwards. Play age is an unspecific designation approximately within the scope of early childhood. Some age-related development periods and examples of defined intervals are: newborn (ages 0–5 weeks); infant (ages 5 weeks – 1 year); toddler (ages 1–3 years); preschooler (ages 3–5 years); school-aged child (ages 5–12 years); adolescent (ages 13–19) The first few years of life are a critical period during which lifelong patterns of health vulnerability are determined by the complex interplay of social determinants. As action can be taken on environmental conditions in order to improve the people’s health outcomes, researchers, governments and policy makers have increasingly been attempting to improve their understanding of the conditions under which children achieve optimal health and developmental outcomes.

Early childhood health and nutrition is a true reflection of countries’ level of development. These health indicators are directly or indirectly linked through existing policies, plans and programmes to countries’ investment in early childhood and respect for children’s rights. Analysis of health and nutrition indicators should include the environmental and social determinants of disease, mortality, poor population, quality of life and the yawning inequality gaps between and within countries.

There are three broad stages of development: early childhood, middle childhood, and adolescence. The definitions of these stages are organized around the primary tasks of development in each stage, though the boundaries of these stages are malleable. Society's ideas about childhood shift over time, and research has led to new understandings of the development that takes place in each stage.

Basic newborn care include immunizing mothers against tetanus, ensuring clean delivery practices in a hygienic birthing environment, drying and wrapping the baby immediately after birth, thus providing the necessary warmth: The promotion of immediate and continuous breastfeeding, immunization and treatment of infections with antibiotics could save the lives of 3 million newborns annually. Improved sanitation and access to clean drinking water can reduce childhood infections and diarrhoea. More than 40% of the world's population does not have access to basic sanitation, and more than one billion people use unsafe sources of drinking water.

Hunger and malnutrition are an unfortunate reality of the world. While people in industrialized societies live in plenty, malnutrition contributes yearly to the death of 5.6 million children less than five years of age in non-industrialized societies. In the developing world, millions of children develop too slowly and millions of people cannot develop their potential to the fullest. Malnutrition has particularly serious effects on children, above all, infectious secondary immune deficiency, learning deficits and, subsequently, school drop-out.

Furthermore, malnutrition threatens girls’ ability to have healthy children in the future and perpetuates the generational cycle of poverty. Good nutrition, in turn, is the cornerstone of survival, health and development not only for current but also future generations. Well-nourished women face fewer risks during pregnancy and labour, and their children develop much better physically and mentally.

An Indian Conceptual Framework for Integrated Child Development

As the word suggests, an indicator gives an "indication" that is intended to reflect a particular situation or an underlying reality, usually by providing an order of magnitude, which means that it is difficult to meet the criteria directly. Indicators are variables that attempt to measure or objectify a quantitative or qualitative collective (especially biodemographic) event in order to support political action and evaluate achievements and goals.

WHO defines them as "variables used to measure changes” Information sources Some indicators may be sensitive to more than one situation or phenomenon; for example, the infant mortality rate is a population health indicator and it is also sensitive enough for use in assessing the general population welfare. However, it may not be specific to any particular health measure because the reduction rate may be the result numerous factors of social and economic development.

Health indicators are used to evaluate the effectiveness of courses of action and effects. An indicator requires a reliable source of information and technical rigour in its construction and interpretation. The principal sources of data used universally are the following:

• Records of demographic events;
• Population and housing census;
• Routine health services records;
• Epidemiological surveillance data;
• Sample surveys (survey population);
• Disease registers;
• Other data sources from other sectors (economic, political and social welfare).

The above are sources of routinely and regularly compiled primary data. If these data are unreliable or non-existent, alternative sources may be sought that are generally indirect estimates of the real value.

The various health-related items for which indicators are constructed are the following:

• health policy (resource allocation, % of GDP invested in child health services, and
  number of hospital beds per x number of inhabitants, etc.);
• socioeconomic conditions (housing, poverty, food availability, literacy rate etc.);

Performance in Public Health Care Health Status: 

(a) activity – availability of services, accessibility, indicators of quality of care, coverage indicators could and hopefully would be disaggregated by population subgroup so that gateways for strategic action could be identified;

health status indicators – these are the most used and can be divided operationally into 4  types:

(1) mortality indicators – widely used, since death is universal, occurs only once and is recorded frequently and systematically;

(2) birth – population’s reproducibility, there being a clear correlation between birth rate and health, socioeconomic and cultural standard;

(3) morbidity – indicators that attempt to estimate the risk of disease (disease burden) to quantify the magnitude and impact; they are difficult to obtain owing to problems of definition, phenomena to be measured and protracted change over time;

(4) quality of life – generally composed of indicators designed to objectify a complex fact such as people’s functional capacity, life expectancy, adaptability to their surroundings, and others.

An indicator is not confined to data on which it is based; it usually contains elements (a threshold, a point of reference, a mode of expression, etc.) that can be used universally to assess the information transmitted and facilitate comparisons in time and space. The use of such indicators has been covered extensively by literature in the various sectors concerned. In fact, information associated with an indicator can cover more than the mere quantification of phenomena and should therefore be selected, analyzed and interpreted by a specialist. Data on the malnutrition prevalence rate will, for example, evaluate its severity in public health terms or its likely implications for the broader development context, taking into account its known effects on health, productivity, schooling and social dynamics. The analysis must therefore be conducted by inter-sectoral groups, when many indicators are involved.
Indicators of the nutritional situation

These indicators should be suitable to characterize each type of malnutrition, which is associated with features of malnutrition itself, the people who suffer from it, where they are, etc., to obtain an indication of the level of risk to various population groups and thus obtain an overview of the situation for the purposes of diagnosis and formulation of overall evaluation strategies – some differentiated and others targeted. It is difficult to determine a person’s nutritional status accurately, and even more so that of a population. This is a global concept that can be gauged only through a series of clinical, physical or functional characteristics, which may be used as additional indicators if a threshold value for separating the malnourished from the well-nourished is incorporated. This task was accomplished after achieving a consensus, mainly on child and adult malnutrition and the widespread lack of three micronutrients with serious implications for people’s health (vitamin A, iodine and iron). First, the individual’s parameters or indices (e.g. weight, arm circumference, haemoglobin level, etc.) were measured. Then, the information was expressed for the population group concerned as a prevalence rate or as the percentage of well-nourished or malnourished people showing the particular type of malnutrition, according to the selected thresholds.

There is no single global indicator to provide a picture of "nutrition". consequently, the particular aspect of nutrition to be characterized energy state, protein, iron, vitamin. A must be stated specifically. That said, there is no synthetic indicator, even on the energy state for example. For this reason, the indicator most relevant to the priority issue will be collected: physical, biochemical, functional, and so on. With regard to the measurement of the population’s general nutritional status, a number of individual physical measurements must be taken to be compared with reference values for determining the status of persons (or the population at large) and constitute the set of relevant indicators to be used in preference to any other. However, in using these indicators, their limited validity must be borne in mind: they provide synthetic nutrition information but do not represent all aspects.
Cause indicators

Once the population groups’ nutritional status and their geographical or socioeconomic distribution are known and goals for improvement have been set, information is needed on the factors that have determined such situation, for example the factors, events or characteristics that affect to some extent the nutritional status of individuals in a particular population.

(a) Nutritional insecurity:- includes food production or supply problems, issues of family and community access to food of good nutritional value, in particular regard to purchasing power, but also includes access to fortified foods, supplementation and treatment in certain cases. These data are collected regularly through information systems in ministries of agriculture and trade.

(b) Environmental health: - access to health services covers water supplies and healthy foods, environmental sanitation, including infectious and parasitic diseases health care systems and their use. The various ministries of health units are responsible for collecting these indicators.

(c) Provision of care and care practices:- this concerns care within the family, social protection afforded by the community or State, of household or community members’ attitudes and practices in providing maternal and child care for the most vulnerable, and the providers’ level of education. This type of indicator is rarely collected on a regular basis. In most cases, information collected through specific community surveys must be supplemented, with emphasis on qualitative aspects.

 

Cite this page