Over 70 per
cent of the children in many Indian states suffer from iron deficiency,
according to the National Family Health Survey-3. About 6.6 million
children have a damaged brain as a result of iodine deficiency; and 1.5
million children suffer from Vitamin A deficiency against the 40 million
the world over (UNICEF 2005 report on the state of the world's children
- 'Childhood Under Threat'). In 2004, pneumonia alone killed 4,10,000
children. Could these health damages have been prevented and the
children saved?
Yes,
says Professor Fiona Stanley of the Australian Telethon Institute for
Child Health Research, in Perth. An early development index can help to
identify priorities for specific action in the community and provide a
baseline for measuring change in children's development over time, she
says.
Stanley, who developed the Australian Early Development Index (AEDI), in
partnership with the Melbourne-based Centre for Community Child Health,
in 2002-03 says this community-level measure of young children's
development has helped state governments and communities Down Under
change their strategic plans and implement key projects aimed at
improving child development.
In New Delhi recently to deliver the prestigious Ramalingaswami Memorial
Lecture on the epidemiology of the cerebral palsies, Stanley has been
exploring the possibility of developing a similar index for India. She
says that United Nations Children's Fund (UNICEF) in India is keen that
the index be pilot tested here some time this year. Stanley believes
that once it is modified to suit Indian conditions and parameters, it
could help the nation tackle bigger social issues.
"AEDI measures how well the country has invested in maternal health,
education, in marginalized children and communities, and shows the
inequalities in society. After we researched the vulnerabilities of
children through this index, parents and communities wanted to know how
they could help in improving development of their children. They became
more involved because AEDI provided them with the evidence that if they
neglect the early years of child development, there can be profound
effects as diverse as low birth weight, child abuse and neglect,
behavior problems, educational problems, mental health problems,
substance abuse, unemployment and juvenile crime. AEDI is a tool to help
understand which policies worked well and what needed to be changed,"
contends Stanley, who was named Australian of the Year in 2003 for her
research on behalf of Australia's children.
The AEDI consists of over 100 questions measuring five developmental
domains: language and cognitive skills; emotional maturity; physical
health and wellbeing; communication skills and general knowledge; and
social competence.
The index was developed in Canada and initially tested in Perth (where
Stanley is based) in 2003 where it was proven that using the tool
provided a strong catalyst for community mobilization around early
childhood. Thereafter, it had a successful trial in 54 Australian
communities - over six states and territories - on more than 30,000
children between 2004 and 2006. This project was funded as an Australian
government initiative under the National Agenda for Early Childhood.
Although Stanley focuses on the importance of using population data and
research to provide significant health, social and economic benefits to
the community, it was not always so. Her life changed after the death of
an aboriginal child that she and a group of doctors had pulled back from
the brink of death from gastroenteritis. Within a year of his release
from the hospital, he once again fell ill but could not be saved.
"The child's death had a profound impact on me and literally changed my
life and my career. It taught me the futility of patching children up
only to send them back into the environment which caused their illness.
It taught me that the disadvantage faced by aboriginal people is complex
and not solved by a single course of action. A child is part of a
community that is also suffering. It is why I became interested in
looking at the bigger picture - a pathway that led me into research. The
fact is that you can't protect children without supporting and involving
their own community," she asserts.
This UNICEF Australian Ambassador for Early Childhood Development
believes that access to good primary health care should be every
Australian's right including the aboriginal community. Aboriginal babies
suffer triple the death rate of non-aboriginal infants, with many dying
from preventable or treatable causes such as infection. If access to
health was universal, aboriginal death rates could have been halved in
10 years, Stanley contends.
Stanley asserts that there is much that Australia can learn from India.
"We have failed to get civil society involvement like India has done.
This is why we have failed to deliver health services to the aboriginal
communities, the high-risk groups, drug users, disadvantaged youth and
the impoverished. The Indian civil society groups organize public
hearings and get the people, especially women, to tell officials exactly
what they need. We haven't been able to get the voices of the
disadvantaged heard about what they want and that is what we should
learn from India," she says.
Stanley has also established the Western Australia Maternal and Child
Health Research Data Base, a unique collection of data on births from
the entire state. It is an effective resource for describing trends in
maternal and child health and the effect of preventive programmes. She
has also established a database of midwives to understand the link
between prenatal and infant deaths. "Midwives are the most important
people as far as early childhood development is concerned. Yet, they are
the most undervalued. I hope something like this can be established in
India, especially as midwives play such an important role here."
She was declared as a Living National Treasure in 2004, by The National
Trust of Australia, an NGO committed to promoting and conserving
Australia's indigenous, natural and historic heritage and her face can
be seen on postage stamps. But Stanley does not want to rest on her
laurels. Being a member of the Prime Minister's Science, Engineering and
Innovation Council, she has come up with a unique idea to ensure speedy
implementation of policies. She is working on a proposal that links the
salary of bureaucrats to a performance indicator that measures the
progress in health, education and other development indices. "If these
indices show an improvement then the bureaucrat should be paid otherwise
there should be some financial penalties and their salaries should be
cut," she contends.
Some might consider this proposal improbable and impractical. But as
Stanley says, many things can wait but not children and if that requires
thinking out of the box, she is ready to do it.
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Yes,
says Professor Fiona Stanley of the Australian Telethon Institute for
Child Health Research, in Perth. An early development index can help to
identify priorities for specific action in the community and provide a
baseline for measuring change in children's development over time, she
says.