Nearly 20,000 children died of various causes in 2017-18 in Maharashtra, according to a statement by a State minister. The age of these children was not revealed but it would be accurate to assume that most were under five years. Primary causes of their death were identified as poor weight at the time of birth, premature delivery, contagious diseases, congenital respiratory illnesses and deformities. More recently three young girls in Delhi, aged between two and eight, are believed to have died due to starvation. Most of these deaths were entirely avoidable — and the fact they happened only highlights the failure of the States in delivering the benefits that are intended for the poor. However, it is not fair to simply blame the political parties governing the two States. The fault lies mostly with the bodies that are responsible for delivering health services and food at the last mile. The State government can be faulted for not adequately monitoring delivery of services by these bodies.

What is also unfortunate is that the lives of the children continue to be lost in States that are among the more prosperous and literate ones, which have also made significant progress in improving their social indicators. Maharashtra government, for instance, can claim that though lives of 20,000 children were lost, its record on under-5 mortality rate (21 per 1,000 live births) is bettered only by Tamil Nadu (19) and Kerala (11). The situation in States such as Uttar Pradesh and Bihar would be far worse given their under-5 mortality rates as high as 47 and 43, respectively.

Lack of adequate and nutritious food is a problem the poor face and often it is the women who make do with the least. When girls and young women in childbearing age fail to get adequate nutrition, they would give birth to underweight children as well as children with various disabilities, including cognitive disabilities. Making fortified food widely available to children and young women can ensure a healthier new generation. Many lives can also be saved with close monitoring of various parameters of newly born children including weight gain and lung function as well as timely vaccination by well-trained healthcare workers.

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