With vast forests and several of India’s famous game parks, Madhya Pradesh is geographically the second largest state in India and has a population of about 72 million (provisional figure, Census 2011). There are a large number of tribal communities here and almost 40 per cent of the state’s inhabitants live below the poverty line, many in rural areas where they subsist on tiny farm plots.
While high rates of malnutrition, child and maternal mortality have challenged this state, UNICEF and the State Government are making a positive impact with a range of programmes. These include training thousands of village health workers to recognize and treat sick babies, and encouraging women to rest and eat well-balanced meals during pregnancy. New hospital units for sick newborns are also saving lives.
Challenges and Opportunities
It’s estimated that two thirds of children in Madhya Pradesh are malnourished. In fact, malnutrition rates for children under five are higher here than in most countries of sub-Saharan Africa. Inextricably linked with high rates of child malnutrition is the large number of new mothers and infants who die shortly after birth.
The state’s maternal mortality rate of 335 per 100,000 live births is higher than the national average and ranks fourth in India. New mothers are vulnerable because many are malnourished and anaemic when they get pregnant, often as teenaged brides. Low literacy levels, particularly among young tribal women, also contribute to the high mortality rates. Nevertheless, children’s access to and enrolment in school has seen an increase and progress is being made to retain more girls and tribal and disadvantaged students.
Other challenges and opportunities:
• The rate of full immunization against common childhood diseases is extremely low.
• The mortality rate for tribal children under five is higher than either the state or national averages.
• Tribal families can face marginalization and exclusion from health and other services.
• Many women have not had access to safe health facilities and trained assistants for childbirth.
• New mothers and babies are exposed to infection and malnutrition from traditions that discourage breastfeeding for several days after birth, and enforce fasting and purification rituals for women.
UNICEF in Action
With addressing child malnutrition and high child mortality rates as its priorities, UNICEF is working hand in hand with the State Government and health workers to promote a cycle of proper health care, hygiene, nutrition and education that begins, in part, by simply encouraging expectant mothers to get adequate meals and rest. Traditionally, many women in Madhya Pradesh are required by husbands and mothers-in-law to work hard at home and in the fields during pregnancy, often damaging their health and that of their unborn child.
Health workers are also teaching women to exclusively breastfeed babies after birth for at least six months
With UNICEF’s support, children in tribal communities now have better access to proper sanitation and clean drinking water, families are learning to give oral rehydration salts and zinc tablets to effectively treat diarrhoea, and parents are being taught the importance of seeking health care promptly at health centres if their child falls ill.
UNICEF promotes the participation of children and young people and provides platforms to help them express their views and opinions. UNICEF actively works with media and civil society to raise awareness of life-saving behaviours and advocate on child rights. Research and evaluations of schemes, budgets and policies from an equity perspective is helping to create an enabling social policy environment as an overarching framework to promote the rights of children and women. The focus is on decentralized district planning and promoting community empowerment as well as strengthening monitoring systems.
Other UNICEF initiatives include:
• Families are encouraged to offer older children balanced meals of generally available and affordable foods, such as rice or chapattis with dal (lentils) and locally grown green leafy vegetables.
• UNICEF assists efforts to ensure children receive full immunization for common childhood diseases.
• Waterborne and sanitation-related diseases are being tackled with UNICEF assistance, particularly in rural areas, with safe drinking water supplies and toilets.
• UNICEF is addressing vitamin A and iron deficiencies in malnourished young women and children with supplements supplied at school and health centres.
• A wider network of delivery rooms with skilled birth assistants is being established with UNICEF support, along with a round-the-clock emergency transport system for women in labour.
• UNICEF provides technical support to the state to set up Special Care New Born units to save lives of sick newborns and Nutritional Rehabilitation Centres to rehabilitate severely acute malnourished children.
• UNICEF actively supports the State Government in implementing the Atal Bal Arogya Mission aimed at decreasing malnutrition and the Rajiv Gandhi Scheme for Empowerment of Adolescent Girls (SABLA), aimed at, among other things, improving the health status of adolescent girls.
Child Protection and Education
• UNICEF supports the State Government in the implementation of the Integrated Child Protection Scheme that aims to create a comprehensive child protection system and services and prevent child abuse with a focus on corporal punishment, sexual exploitation, trafficking, child marriage, child labour and female foeticide.
• Children, and especially girls from disadvantaged and tribal groups, are being supported to attend school and to complete their basic education.
• Parents and communities are being encouraged to monitor quality standards at school to promote child-friendly schools to increase enrolment and retention.
• UNICEF supports the State Government in establishing special juvenile police units through technical and financial assistance.
• UNICEF supports the State Aids Control Society in reaching out to communities with correct information on HIV/AIDS and extending support to affected children.
UNICEF State Office for Madhya Pradesh
Plot No 41-42, Polytechnic Colony
Tel: 0755 266 1556, 0755 266 1555,
Bhopal, Madhya Pradesh - 462013
Fax: 0755- 266 1558