Starved of will

While the National Health Rural Mission (NHRM) operates at the village level, no programmes effectively encompass the city poor.

India doesn’t have a hold on the number of infants who may be on the verge of malnutrition. After all, no ‘official’ figures were released after the Health Ministry expressed doubts over the World Bank’s report that child malnutrition “is a risk factor for 22.4 per cent of India’s total burden of disease”. India, clearly, doesn’t have the facility or wherewithal to track and monitor the efficiency of its mother-and-infant healthcare projects. Worse, it’s not bothered. Since the admission of seven infants to Mumbai’s Rajawadi Hospital, a blame game has erupted — the authorities denying the very existence of malnutrition.

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The infants allegedly slipped through the healthcare net for three reasons. One, being born to illegal immigrants they didn’t officially exist and thus couldn’t avail of State help. Two, even in their impoverishment, the families weren’t Below Poverty Line — which, officials say, has been lowered so that fewer can be covered. Three, there’s no distinction made between urban and rural poverty — despite the two having vastly different parameters. Surely, availability of healthcare facilities shouldn’t be defined by demographic profiles or locational disadvantages.

While the National Health Rural Mission (NHRM) operates at the village level, no programmes effectively encompass the city poor. The anganwadi programmes and the Integrated Child Development Scheme (ICDS) also focus on villages. Even here, efficiency is doubtful. The ICDS is serving no useful purpose in mapping a child’s growth and those who can’t visit an anganwadi centre are beyond coverage. The ICDS was to be integrated with the NRHM to avoid duplication of functions. But the situation remains static. A multi-layered but poorly implemented health policy continues to operate, even as the urban poor’s state worsens.

The Centre’s rhetoric in denying WHO concerns on child and maternal health has blown up in its face. The urban poor are worse off than the rural poor. They have little community-level support and even less State support. At the very least, the State could turn this abysmal situation into a lesson and do something about the nation’s health.