A child-friendly city is often equated with simplifying the public transit system to the point that even a child can easily navigate its intricacies. Nonetheless, it is equally essential to create an environment wherein children do not just survive but thrive, free from ailments as well as exploitation, irrespective of their ethnicity, income, religion, gender, or ability.
If our children are not healthy both physically and mentally, then can we call our cities child-friendly? As per the estimates, about 40 per cent of children in India are vulnerable or live in challenging circumstances, which include children living in slums, homeless children, and child labourers, among others.
These economic and social deprivations breed malnutrition, diseases caused by a dearth of sanitary living conditions, clean drinking water, and incomplete immunisation. In India, 50 out of the 1,000 live births do not complete first year of their lives, and about 1.2 lakh children under the age of five succumb to diarrhoea alone.
Cities’ shame
The Status of Children in Urban India Baseline Study 2018 revealed that in India, out of 472 million children below 18 years of age, 27.4 per cent live in cities, and 8.1 million children below the age of six live in slums. Also, 90 per cent of the migrant children in the 0–6 age group do not have access to government schemes like Integrated Child Development Scheme (ICDS), and 15.3 per cent were found homeless.
Apart from the lack of clean drinking water, unsanitary living conditions are also contributing factors to unhealthy children. The National Family Health Survey (NFHS)-5 report revealed that in urban centres of India, 45 per cent of households did not have a dedicated piped water supply in their home. However, this number has come down to 20 per cent as per the Ministry of Jal Shakti. However, some inequality still persists at the city and local levels, and local authorities need to step up and address these challenges at the micro-level.
Therefore, to make our cities children-friendly and to ensure their healthy development devoid of exploitation, the improvement of slums and the eradication of poverty are paramount. For this reason, the Indian Constitution has delegated both responsibilities to urban local bodies.
Malnutrition’s toll
Malnutrition is another key aspect that demands immediate and effective, comprehensive interventions. As per NFHS-5’s data, nearly 30.1 per cent of children reported stunted (being shorter for their age) in India, while 27.3 per cent of children were underweight, and 18.5 per cent reported being thinner for their height. Similarly, nearly 65 per cent of the children below the age of five are suffering from anaemia. This number has only increased if compared to NFHS-4. According to UNICEF, addressing this nutritional challenge alone will reduce 68 per cent of child mortality and can enable a better future for 41 million stunted and 22 million children suffering from wasting.
Preventable tragedy
UNICEF’s “The State of the World’s Children 2023” notes that fully vaccinated children in India between 8 and 11 years of age show 6 to 12 per cent improvement in reading, writing, and mathematics. India and the world were making progress in that direction. At the turn of the 21st century, there were nearly 22.3 million zero-dosed (unvaccinated) children, which was reduced to 15.4 million in 2010 but increased to 18.2 million in 2021 due to the advent of the pandemic.
UNICEF says that due to COVID-19, 67 million children partially or entirely missed out on their routine immunisation, while 48 million completely missed out on their routine, dragging the vaccination rates back to their pre-2008 levels. India’s case has not been all that different. In terms of the total number of unvaccinated children, India stood in 19th place with 2.5 million zero-dose children.
Breaking the cycle
As mentioned earlier, ULBs play a significant role in effectively implementing central and state-level initiatives like the ICDS. But they also have direct responsibility for essential services such as providing clean drinking water, sanitation, poverty alleviation, and slum improvement or upgradation.
Civic bodies efforts in this direction could best be understood by the funds they allocate to improve access to essential services, along with reducing disparities. The Brihanmumbai Municipal Corporation, the richest corporation in India, allocated `4,087 crore to public health; a cumulative amount of `351 crore was allocated for slum clearance, slum improvement, and poverty alleviation out of its `60,000 crore budget for 2024–25. The water supply and sewerage sectors got `3,420 crore and `6,367 crore, respectively.
On the other hand, Bruhat Bengaluru Mahanagara Palike, in its 2023–24 budget, allocated only `241 crores plus `103 crores for public health—general and medical. However, out of the total health budget,’ repairs‘ and maintenance of hospital equipment and medical supplies to hospitals’ and ‘healthcare centres’ got a meagre `2.25 crore. There was no mention of poverty alleviation in the civic bodies’ budget. However, `6 crore and `38 crore have been earmarked for slum rehabilitation, and water supply. Civic bodies need to enhance their expenditure on health sevice for improving over liveability.
It is important to comprehend that investing in children and enhancing access to fundamental services is not solely a welfare measure but an investment in the future. Only through prioritising child health, sanitation, slum upgradation, and poverty alleviation could ULBs unlock the Kid-topia—the genuine potential of every child—within their jurisdiction, not just for the privileged few but for all the children.
Addressing the nutrition challenge alone will reduce 68 per cent of child mortality and can enable a better future for 41 million stunted and 22 million wasted children.