Strengthening partnerships to improve the lives of children and women
Assam, the largest amongst the north-eastern states of India, with a population of 27 million (Census 2001) provides both challenges and opportunities to development planners. The state registered a decadal growth rate of 18.8% in 1991 – 2001, less than the national average and less than the previous decade (24.2 %). Primarily a rural state, it has not been able to make much progress in agricultural growth. The proportion of Below-Poverty-Line (BPL) families was 36 percent in 1999-2000.
The challenges arise from a combination of its proneness to natural disasters (it falls in Zone V – the highest – in terms of environmental vulnerability), a long-running insurgency and ethnic conflict; high unemployment among educated youth and wide variation in development indicators.
Children under 6 years of age account for 16% of the population (4.4 million), marginally above the national average of 15.4%. The sex ratio among children in the 0-6 age group is 964 girls to 1000 boys. The overall sex ratio is 932.
Assam has one of the highest maternal mortality rates in India, 407/100,000 live births. Less than 60% of women receive antenatal check-ups. Institutional delivery is extremely low at 17.6 % and skilled attendants conduct only 21.4 % of non-institutional deliveries.
The infant mortality rate (IMR) at 69.5/1,000 live births remains very high. Besides high neonatal mortality, infectious diseases and vaccine preventable diseases are also responsible for the high level of infant deaths. Only 17% of children receive full immunisation.
The picture in terms of child development and nutrition, water and sanitation, child protection and education portrays a similar mix of complex challenges and diverse opportunities.
Of particular concern is the recurring cycle of natural disasters such as flooding, landslides and vulnerability to earthquakes on the one hand and political strife and ethnic violence on the other. Floods have impeded the technological transformation of agriculture in Assam. Farmers do not apply costly inputs such as fertilizers and HYV seeds for the fear of their being washed away by floods. 92.6 per cent of the cultivated land is flood prone.
The combined result is a serious impact on service delivery and livelihoods of people. Entire communities are displaced and become more vulnerable to sliding down the poverty spiral.
Until 2006 Assam was covered by the UNICEF West Bengal state office in Kolkata. In mid-2006 a full-fledged Assam State Office came into being. The Government of Assam-UNICEF cooperation focuses on two critical age groups: children under 3 years of age and school-going children.
For the Under-3 group, UNICEF works with the Health Department to improve home-based healthcare practices; improve basic services; use of health services; promoting better infant feeding practices and use of institutional child-care services.
UNICEF has a long-standing record of supporting immunisation services in Assam. The focus is on strengthening and expanding routine immunisation services, cold chain, injection safety, training, microplanning, monitoring and programme communication and advocacy.
For school going children (5-14 years), UNICEF’s strategy focuses on enhancing learning levels of children in primary school; improving health and hygiene practices; improving the teaching-learning environment and practices in schools; policy review and institutional reforms.
Upgrading primary school infrastructure such as toilets and water supply are also key thrust areas. UNICEF is facilitating the state government to implement the Total Sanitation Campaign to promote rural and school sanitation and also support an action plan for fluoride mitigation in two districts.
Kamrup district was the first one to receive the benefits of a district-wide School Sanitation and Health (SSHE) initiative that started in 1999 and was co-sponsored by the Government of Assam and UNICEF. 748 schools in the district have completed the program and 1,154 schools are currently in their final stages, since the program began.
Cross-cutting activities in child protection also touch this age group. UNICEF’s endeavours focus on an improved child rights scenario, such as improving knowledge and skill base; behaviour and attitudinal change to reduce child labour and last but not least, an increased public discourse around the issues of child labour and protection of children in difficult circumstances.
As part of disaster preparedness, UNICEF organised training of public health engineers and key representatives of major NGOs in the state on “Disaster Preparedness on Public Health”. The State Government has developed a proposal for “Vulnerability Mapping for the state” with UNICEF support. The Vulnerability Mapping exercise will generate a disaster preparedness database.
It is often said that development of Assam is intricately linked with the development of the entire north-east of India. UNICEF is strategically poised to play a catalytic role in advocating for and securing the rights of children and women in this sensitive area of India in the new millennium.