4
Investing in South Asian Children
The South Asian High Level Meeting on Children has been convened as
a South Asian Initiative under the Global Movement for Children and in
preparation for the Special Session of the UN General Assembly on
Children, 19-21 September 2001. It is another step in monitoring the
progress for children and reaffirming commitments made. The major
outcome expected from the meeting is a commitment and sharing of
ideas and strategies to move away from ‘business as usual’ since current
progress for children is below expectations and to ‘make a difference’
for children early in this millennium. Specific objectives include:
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To review progress made towards achieving World Summit Goals
for Children during the past decade in each country and in the
South Asia region as a whole.
To discuss the imperative of investing adequately in the rights
and well being of all children, and the cost to society of underinvestment in children.
To discuss the range of new partnerships required - between
governments, the corporate sector, civil society organizations and
young people - to ensure (a) adequate investments in the rights
and well-being of all children in South Asia; (b) that goals for
children are met in the near future.
To review selected key issues that affect children in the region,
and to consider new investment strategies that could make a
significant difference to the lives of all children and to the
future of societies in South Asia.
Over 40 per cent of South Asia’s population are children under 18 years
of age, half a billion children. These children are the future of their
countries and with them lie the hopes and dreams of the current
generation of adults and of future generations of children. Many
outcomes are necessary for them to fulfil their responsibilities ranging
from the pursuit of individual self-interest and happiness to achieving
sustainable development. Sustainable development takes account of
future generations, preserving the physical capital and investing in
human capital in the current and in future generations. The outcomes
are interdependent and the Global Movement for Children highlights three
critical ones:
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A good start in life for each child.
Completion of basic education of good quality for each child.
The opportunity for adolescents to develop their individual
capacities to the fullest.
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The Movement can have many approaches, strategies and
initiatives - but all towards achieving these three outcomes and
actions related to their fulfillment. The South Asia meeting is a
step in that direction. In that context, this paper summarizes the case
for investing in children, the costs of not investing and invites ideas
on how the commitments of goals and actions can be translated into
reality.
This paper highlights the significant progress that has been made, points
to the disparities that remain and the need for acceleration of actions
to achieve the goals and commitments made for children. It argues
that the level of investment required to achieve significant further gains
for children is not only an obligation but that it is affordable. The
paper points to five critical actions that need to be promoted:
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leadership at all levels of society;
giving voice to childrens’ views and ideas and allowing them to
hold decision-makers accountable;
mobilising additional resources, particularly government
expenditure for the well-being of children;
promoting partnerships with the corporate sector to increase in
investments and enter into dialogue for improved results;
and building on the successful lessons of partnerships with and
among civil society, NGOs and multi-lateral and bilateral
agencies.
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Progress, but still a long way to go
In the past decade, South Asia has achieved much for which it
can be proud of in terms of progress in human development.
Many commitments were made, many achievements are seen,
but much remains to be done. South Asia now needs to address
the disparities that still exist in many of the human development
indicators - disparities across states, districts, marginalised
communities, rural and urban, rich and poor and those based
on gender. South Asia also needs to move faster in achieving
the goals and commitments set for children and human
development. These are the two critical areas for emphasis
across most of the countries.
In a region which is marked as much by its homogeneity as by its
immense diversity averages and national trends mask a more
complete picture. Indeed, from a human rights perspective, it is
meaningless to look at averages if many millions of children fall
below the average and the range of variation is huge. Wherever
possible, therefore, we must look at the disparities that prevail in
the outcomes for children. It is also necessary to look at individual
countries separately and at state and district level data, since some
countries and states have made major strides but others with the
largest populations in the region have a long way to go. But the
total and average indicators are themselves still a sobering reminder
that the region as a whole has a long way to go. And we must
recognize that in many areas, such as protection from abuse and
violence and gender based differences in attitudes and behaviour,
indicators and data may not be available but they are no less
important for the outcomes for children.
Although the South Asian Association for Regional Co-operation
(SAARC) goal was not achieved for Under-5 mortality, significant
reductions have been achieved in most countries of the region. In
India under-five mortality has stagnated at an unacceptably high
level with some states accounting for the high national and regional
averages. Stagnation is also seen in Pakistan. The sharp declines
in Bangladesh and the long history of achievements in Sri Lanka
are evidence that acceleration and sustaining the gains is possible.
3
Trends in immunisation as captured by the data on
measles are also encouraging. Nepal has shown how
it can be accelerated, Sri Lanka how it can be
maintained.
The great success stories in the region are use
of modern contraception, trends in teenage
marriage, improved water supply and net
enrollment of boys and girls in primary
school. The trend in use of modern contraception
across the region is certainly not business as usual.
Sharp increases are seen in many countries of the
region and states. However, fertility remains high in
some countries such as Bhutan, Nepal and Pakistan,
and in some of the larger states in India. High
contraception use alone is not a solution to declines
in fertility. As many studies in other parts of the world
have shown reduction in fertility is very much a factor
of education for girls and women. It is now well known
that educated mothers have fewer children.
Recent data on trends in marriage also shows sharp
declines in Bangladesh, India, Nepal, Pakistan and the
sustaining of the low trend in Sri Lanka.
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Primary school enrollment has show n
impressive gains in the region. In virtually all
countries there have been significant increases in gross
and net enrollment. But retention of enrolled students,
attendance, completion and low learning achievement
are emerging as major challenges even as access for
those still not in school is addressed. Female literacy
rates have declined slowly and are still unacceptably
high.
Education profile
Bangladesh
Nepal
Sri Lanka
adult literacy rate
100
80
public expenditure in basic
education, %
60
40
youth literacy
20
0
primary enrolment
secondary enrolment
survival in gr 5
Source: UNDP, Human Development Report, 2000; EFA
Sub-Regional Report for Asia and Pacific 2000
Improvement in education, but much to
be done to ensure retention, completion,
adult literacy and secondary school
enrollment in some of the larger
countries for which data exists.
Impressive gains are seen in access to
improved drinking water. But here again there
is danger of the gains being eroded through declines
in the ground water table and contamination of ground
water due to arsenic, flouride, iron, and salt water
intrusion. Millions of people do not have water in the
hot summer months in both rural and urban areas.
Arsenic contamination has affected a number of
villages in the region but efforts are underway to
mitigate its effects. Increasingly emphasis has to be
given as much to water resource management as to
water extraction.
5
Progress in eliminating malnutrition, access to environmental sanitation and hygienic practices has
been particularly slow. Both in terms
of proportions and numbers, there are
more malnourished children in South Asia
than in any other region. Good hygiene
and environmental sanitation is important
for overcoming protein-energy malnutrition, anaemia and low-birth weight. Micronutrient deficiencies can still be addressed as has been seen in the great success stories in the region on Vitamin A and
salt iodisation.
6
South Asia Progress Report on Children
Progress but still a long way to go…
Some states/ provinces or regions in countries have
remained stagnant in many key indicators.
The progress:
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In 1990 6.8 million children under-5 are estimated to have died in South Asia. In 1999 this has
declined to 3.7 million.
Routine immunisation has managed to maintain or even increase coverage from 1990 levels.
Polio is on the verge of eradication from South Asia.
Vitamin A supplementation has shown dramatic increases where it has been piggybacked on
the national immunisation days for polio.
Gains have been made in net enrollment with 88 per cent for boys and 66 per cent for girls, but
roughly 50 million children are not going to school in the ages 5-14 years, the same number
as in 1990.
Access to safe water has shown impressive gains. In 1999 only 10 per cent of the populations
of South Asia or about 170 million people is without access to improved water.
Fewer children below the age of 15 are marrying early than 10 years ago. Whereas about
30 per cent were married in 1990 towards the end of the last millennium this was down to about
20 per cent.
Use of modern contraceptives has improved dramatically between 1990 and 2000
The Tasks Ahead:
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Half a billion people in the region live in poverty, under $1 per day, half of these are estimated to be children or about 250 million children.
Little has been done to address anaemia in the region as a whole.
While there has been a steady decline in many of the smaller countries of the region, about
80 million children in the region are still stunted and 21 million children will remain
stunted in 2015 on present trends.
More than 600 million households are not consuming adequately iodized salt.
40 per cent of the 150 million children currently enrolled or about 70 million children are
dropping out before completing primary school - more girls than boys will leave school. Of
those that are in school it is questionable as to what they are learning. 220 million of today’s girls and women will be illiterate in 2015.
About 40 million or 14 in every 100 children are engaged in child labour in South Asia.
About two-thirds or 800 million are without access to sanitation. At present trends, the
goal of universal access to sanitation will not be reached until the next millennium.
50 per cent of the world’s maternal deaths occur in South Asia - almost 300,000 women
die from causes related to pregnancy and childbirth.
Around 3.6 million people in South Asia, mainly in India, are already living with HIV/
AIDS with alarming trends in some of the countries. In India, over 50 per cent of new infections take place among young people below 29 years.
There are about 2.3 million refugees and 28 million internally displaced persons (IDPs) in
the region. More than half of the IDPs are children - almost 15 million - who are highly
vulnerable to sickness, violence, abuse and exploitation.
Domestic violence against women is shockingly high in South Asia: in Nepal 77 per
cent of women have suffered at least once; in Sri Lanka 60 per cent; in Bangladesh 47 per
cent;
Other abuses on which data is difficult to obtain such as honor killings; dowry death and
acid attacks on women prevail.
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Health profile
India
Pakistan
Bangladesh
low birthweight, %
100
80
60
40
doctors per 100,000 people
20
TB immunization, %
0
ORT use rate, %
measles immunization, %
Source: UNDP, Human Development Report, 1999 and 2000
Immunisation
Health profile
low birthweight, %
100
80
Sri Lanka
Nepal
60
40
doctors per 100,000 people
20
TB immunization, %
0
ORT use rate, %
has improved
but low-birth
weight and
access to
measles immunization, %
Source: UNDP, Human Development Report, 1999 and 2000
medical
care still a
major issue.
Health profile
TB immunization, %
150
South Asia
East Asia
SSA
100
50
nurses per 100,000 people
0
doctors per 100,000 people
8
measles immunization, %
4
The poor are worse off
For virtually every indicator, the poor are worse off than the rich
and in many cases by a great deal. Analyses done by the World Bank
shows for example that in Bangladesh for every 1000 live births 39.7
more children die in infancy among the poorest 20 per cent than the
richest 20 per cent. For India the differential is 56 live births, for Nepal,
32.4 live births, and for Pakistan 26.2.
Rich and poor gap in social indicators
Bangladesh, 1998
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Pakistan, 1991
under 5 mortality rate
13
educational attainment,
gr 5, %
antenatal visit, %
eudcational attainment, gr 5
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11
antenatal visit, %
under 5 mortality rate
delivery by trained person, %
infant mortality rate
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delivery by medically trained person, %
9
seeking care during ARI, %
seeking care during ARI, %
7
immunization coverage, %
7
stunting, %
ORT use, %
immunization coverage, %
5
stunting, %
5
use of modern contraceptives, %
infant mortality rate
use of modern contraceptives, %
ORT use, %
3
3
ARI prevalence, %
prevalence of ARI, %
prevalence of diarrhoea, %
1
prevalence of diarrhoea, %
1
total fertility rate
0
20
40
60
80
total fertility rate
0
20
40
Nepal, 1996
U5MR
Educational attainment, Gr 5
11
antenatal visits, %
full immunization, %
Infant mortality rate
delivery by medically trained person, %
use of modern
stunted, %
7
5
use of ORT, %
Total fertility rate
0
20
40
60
under 5 mortality rate
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delivery by medically trained person, %
11
infant mortality rate
10
antenatal visits, %
9
educational attainment, gr 5, %
8
immunization coverage, %
7
use of modern contraceptives, %
6
stunting, %
seeking care during ARI, %
4
Prevalence of diarrhoea, %
ARI prevalence, %
1
13
5
Seeking care during ARI, %
3
80
India, 1993
13
9
60
80
ORT use, %
3
ARI prevalence, %
2
total fertility rate
1
prevalence of diarrhoea
0
50
100
150
Source: World Bank (1999 and 2000).
In the case of malnutrition, the poorest have 27 per cent more of their
children stunted in Bangladesh, in India 24.4 per cent, in Nepal 27.2,
and in Pakistan 28.2. The poor have higher fertility rates, and poorer
access to health care facilities as measured by both delivery by medically
trained personnel.
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Girls, particularly of the poor
and marginalised, are worse off
Girls in South Asia have made progress.
There is improvement in girls enrollment as seen
by the trends in Bhutan, Bangladesh, Maldives
and large parts of India and Pakistan. Sri Lanka
has not had much gender disparity in social
indicators for many years. But South Asia is still
t he most ge nder ins e nsitive re g io n .
Discrimination against girls and women starts
early from the womb and lasts to the grave.
More girls than boys are out of school in the
region as a whole. More girls than boys will
leave primary school before completion. More
girls than boys are engaged in child labour,
although their labour is hidden, particularly
as child domestic workers. More girls are
sexually abused than boys. More girls than boys
are trafficked for prostitution, though whatever
the number it is an equally abhorrent practice.
Girls are often less able to protect themselves
physically and are brought up to be submissive
and obedient. Studies show that girls begin
working in the home at a younger age than their
brothers, and work on average seven more hours
a week than boys. Such attitudes towards girls
perpetuate the low social and economic status
of women.
Women's survival, health and education
life expectancy (% male)
120
100
80
births attended by trained
adult literacy rate (% male)
60
health personnel (%)
40
20
0
TT immunization (%)
primary enrolment (% male)
contraceptive prevalence (%)
Nepal
Afghanistan
Bhutan
Maldives
Source: State of the World's Children, 2001
Women’s survival, health and education status
life expectancy (% male)
120
births attended by
70
trained health personnel
adult literacy rate (%
male)
20
(%)
-30
primary enrolment (%
TT immunization (%)
male)
India
Pakistan
contraceptive prevalence
Sri Lanka
(%)
Bangladesh
Women's survival, health and education status
For virtually every indicator
girls and women are still
worse off than boys and men
in South Asia and in
comparison to other regions.
South Asia
SSA
East Asia
life expectancy (% male)
120
births attended by trained
health personnel (%)
70
20
adult literacy rate (% male)
-30
TT immunization (%)
primary enrolment (% male)
contraceptive prevalence (%)
11
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The root causes for slow progress in some of the
indicators are well-known …….. but so are ways
of overcoming them
The root causes of the slow progress are well known, although there
may not be consensus on all of them. Two major underlying causes
in South Asia are poverty and the gender insensitivity that
characterizes this region.
Poverty is a major underlying cause for the non-fulfillment of the rights
of all children. Poverty strikes children early - even in the womb. Poor
malnourished mothers typically give birth to underweight babies. Babies
born into poverty are further ravaged through malnutrition and disease.
The most critical period of development of a child’s brain is between 03 years of age.
Poverty robs children of the nurturing care that is crucial for their mental
and psychological development to lead healthy and productive lives,
either through the ignorance of parents of what is needed to ensure
early child development, or through the pressures of earning a living
for the family. Impoverished children become transmitters of poverty,
as parents, to the next generation. In a vicious cycle malnourished
mothers give birth to underweight babies; parents lacking access to
crucial information are unable to optimally feed and care for their
children; and illiterate parents cannot support children in their learning
process. Poverty is a root cause of poor health and nutrition, child
labour, of HIV/AIDS infections, of trafficking in women and children,
and of ignorance and denial of rights.
But is poverty a legitimate excuse for slow progress in meeting the
rights of all children? Although higher levels of economic growth would
undoubtedly help in reducing the levels of poverty, we now know that
dramatic achievements in human development are possible even at low
rates of economic growth. We also know that many countries have grown
fast without a commensurate impact on the living conditions, and some
countries have achieved high quality of life despite relatively moderate
economic growth. Even with high levels of economic growth, much
depends on how the fruits of that growth are used in the specific fields
of public education and health and in reducing absolute poverty.
Poverty is the worst
form of violence
Mahatma Gandhi
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The examples of successes in human development even with moderate rates
of economic growth are at our doorsteps in Sri Lanka, Kerala State in India,
Bhutan and the Maldives. These countries have achieved higher levels of
human development than would be expected on the basis of the GNP per
capita of their populations. Other examples are not hard to find. The socalled ‘East Asian Miracle’ shows that early investments in primary education
laid the foundations for long-term economic growth in these countries.
While economic growth is very important it is not in itself a guarantor of
investments in the welfare of children. More importantly, even without high
levels of economic growth and in situations of poverty, it is possible to
achieve results in human and child development, especially in South Asia
where adequate resources and capacities exist.
There is, therefore, no basic conflict in regarding economic
growth to be very important, yet taking it to be an insufficient
basis for human development, and at the same time arguing
that human development is possible despite low rates of
economic growth.
Poverty is a denial of human rights but it is not an excuse for
ensuring human security and protection for all children. Poverty
reduction begins with children.
There is a long tradition in both the religions and values in the region of ensuring the rights of children, which predates the Convention on the Rights of the Child (CRC)
CRC is not an imposition from the North. It promotes rights, which have
been recognised by ancient religious sages. It is changing societal values and economic systems that have had detrimental effects resulting
in the violation of children’s rights. The core scriptures of most religions
[of South Asia] clearly establish more rights and protection for the child
than does the CRC. States parties in South Asia, through the CRC, have
promised children to protect, fulfil and ensure their rights. Governments
cannot hide behind religion, tradition and culture to absolve themselves
of this obligation. In South Asia, the right to education has been denied
to the majority of children. Not only are girls denied education also boys
from poorer sections of the community and from low caste families have
had no access to education. This violation of the child’s right to education has taken place in the name of religion, even though the core scriptures of all religions are in favour of children’s education. In most religions it is the duty of parents or guardians to ensure their children’s religious, moral, physical and scientific education, which ensures wholesome
development.’
Source: M. Arole (1998) in ‘Religion and Rights of Children and Women in South Asia’.
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South Asia has been characterized as the ‘most gender insensitive’ region
in the world. This conclusion has come about due to the entrenched
discrimination that exists against girls and women. Various indicators can
be used such as the millions of “missing” women as a result of family
planning practices, female foeticide and the growing industry of screening
for child sex during pregnancy.
Discrimination is also evident in the high levels of domestic violence against
women, in honour killings, in acid throwing, in dowry deaths and in
trafficking in women and girls. These are all manifestations of deep-rooted
attitudes and behaviours, which have been transmitted through generations
and perpetuated within families, communities and the social and political
systems. Gender equity strategies should focus not only on activities
involving women and girls, but also on encouraging and supporting positive
attitudes and behaviour of men and boys towards the opposite sex.
South Asia being predominantly partriarchal entitles father and sons to have
move access and control over resources, decision-making, participation and
mobility. As primary care givers women and girls have to less bargaining
power to provide the right to survival, development and protection for their
children and themselves.
Overcoming gender-based disparities is a much more
challenging task - even more so than overcoming poverty, but
the two challenges are inter-related. Experience has shown
that education of girls and women is critical for results in
overcoming gender-based disparities.
There is no doubt that tackling the root causes for the current situation of
children will be complex and difficult. Many strategies have been tried
and many lessons learned but we are still in a ‘business as usual’ mode
since many children are still denied their rights.
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The commitments have been made
All the nations of South Asia have made commitments to achieve the outcomes for
children - their survival, growth, development and protection - that will be reaffirmed
again at the United Nations Special Session in September 2001. These international
commitments are a testimony to the fact that the desire exists. These are reflected in
the constitutions of each South Asian country. In many cases these commitments came
well before the CRC, which has been ratified by all the countries of South Asia.
International Commitments
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Universal Declaration of Human Rights, December 1948
Declaration of the Rights of the Child, 1959
International Covenant on Civil and Political
Rights, December 1966
International Covenant on Economic, Social and
Cultural Rights, December, 1966
ILO Convention 138 concerning Minimum Age of
Admission to Employment, June 1973
United Nations Standard Minimum rules for the
Administration of Juvenile Justice, November
1985
Standard Rules on the Equalization of Opportunities for Persons with Disabilities, December
1993
Convention on the Rights of the Child
November 1989
Convention on elimination of all for ms of
discrimination against women December 1979
World Summit for Children, Sept. 1990
International Conference on Population and
Development, September 1994
World Summit for Social Development
Fourth World Conference on Women: Action for
Equality, Development and Peace, March 1995
SAARC Colombo Resolution on Children, 1992
SAARC Rawalpindi Resolution on Children of
South Asia, 1996
Education for All, 2001
(Not all commitments by all South Asian countries.)
National Commitments
“The State shall adopt effective measures for the purpose of ... establishing ... universal system of education and extending free and compulsory education,
... [and] removing illiteracy within such time as may
be determined by law.” Constitution of Bangladesh.
“The future of Bhutan lies in the hands of our children.” H.M. King Jigme Singye Wangchuck
“No child below the age of fourteen years shall be
employed to work in any factory or mine or engaged
in any other hazardous employment” Constitution of
India.
“The State shall make necessary arrangements to
safeguard the rights and interests of children and
shall ensure that they are not exploited, and shall
make gradual arrangements for free education.” Constitution of Nepal
“The State shall… secure the well-being of its
people….provide basic necessities of life, such as
food, clothing, housing, education, medical relief, for
all such citizens, irrespective of sex, caste, creed or
race, as are permanently or temporarily unable to
earn their livelihood on account of infirmity, sickness
or unemployment”. Constitution of Pakistan.
“..Principle shall guide the state…The realisation of
an adequate standard of living for all citizens and
their families including adequate food, clothing, housing and medical care” Constitution of Sri Lanka.
The long list of commitments, leave no doubt that there is no lack of commitment in
South Asia.
The ratification of the CRC has given all children under the age of 18 an inviolable right
to survival, development, protection and participation. States and the international
community have a moral and a legal obligation of ensuring that the rights of all children
are fulfilled. This can only be done within the available resources. There is an obligation
to mobilise all available resources. Meeting these obligations is no longer an issue of
charity or discretion. As a leading feminist Mary Wollstonecraft put it in 1792, “It is
justice, not charity, that is wanting in this world”.
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The case for investing in children has always been
strong. Large- scale successes in investing in
children are at our doorsteps. The evidence exists.
There should be no need to make the moral and ethical case
for investing in children - we were all children once, or are
children today, and are likely to have our own children
tomorrow.
There should be no need to make the legal case for investing in children.
The Convention on the Rights of the Child, ratified by all South Asian
Countries imposes an obligation on all States to invest ‘maximum available
resources’ to fulfill the rights of each child.
Beyond the normative, there is also a compelling economic and social case.
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Investing in early child development
The first three years of a child’s life are
by far the most critical not only for its
survival but also for its development in
future years. Most brain development
happens in these three years. The brain
cells of a new infant proliferate, synapses
crackle and the patterns of a lifetime are
established. In this short 36-mo nth
period, the child develops its abilities to
think and speak, learn and reason and lay
t he fo u ndatio ns for its values and
behaviour as adults.
Research and clinical work have found that
experiences of the infant and young child
provide the foundation for long-term
physical and mental health as well as
cognitive development. Neurologists now
know that the hu man brain achieves
approximately 85 per cent of its adult size
by the age 2 1/2 years, and 90 per cent
of its total growth by age 3. This increase
in brain size comes as a result of changes
in cell size and in the complexity of
connections among brain cells. Many
factors in the environment contribute to
this critical shaping of cell connections in
early childho o d, includ i ng phy s ical,
emotional and cultural factors that affect
the care provided to children.
Critical Periods for Some Components of School Readiness
Critical Period
Critical Period Wanes
Binocular Vision
Emotional Control
Habitual Ways of Responding
Peer Social Skills
Language
Symbols
Relative Quantity
0
1
2
3
4
Age(Years)
5
6
7
Sources: adapted from Begley, 1996, pp 5859 Reprinted in Zero to Six: "The Basis of
School Readiness" R-97-BE, Gillian Dohery
May 1997 Applies Research Branch
Strategic Policy, Human Resource
Development Canada.
The Mismatch Between Opportunity and Investment
Brain's
"Malleability"
Spending on
Health, Education
and Welfare
0
3
10
Headstart
Age
Welfare
Public Education
70
Medicar
e
Social Security
Research Medicaid
Source: CIVITAS Initiative/ Chicago
CIVITAS Child Trauma Program/ Houston
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The period of early child development is thus unique - physically,
mentally, emotionally and socially. It is a period of both opportunity
and vulnerability. But it is ironical that investments are lowest in
the early years where returns to investments are highest.
Some of the factors, which affect development in these early years, are
parental stimulation or emotional support; resources constraints faced
by children due to low family income or inadequate nutrition or health
care. In South Asia, with its high level of poverty and adult illiteracy
and the large number of children who will not complete even primary
school or will not learn even if in school, the challenges are on both
fronts. First, to inform parents, families, caregivers of the importance
of the early years and what they can do to stimulate their children;
and second to provide them the necessary nurturing care, nutrition and
health that is vital for their development. In the past, actions have
focused more on service provision but we now know that education of
parents and adoption of caring practices by parents is equally important.
However, large-scale communication efforts to empower parents/
caregivers with the knowledge to give their children the best possible
start in life are still in their infancy. Some important initiatives have
been taken in countries such as the Maldives and there are a number of
smaller impressive on-going initiatives to build on.
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Bhutan - the pursuit of happiness through investing in children
Bhutan has emphasized that it is the pursuit of gross national happiness that is more important
than only the pursuit of gross national product. Before 1960, a Bhutanese child could expect to
live only 35 years, today it is almost double that figure at 66 years. Around 1960 there were only
11 primary schools with less than 500 children, today 61 per cent of boys and girls can expect to
complete primary school.
Bhutan’s success has been achieved through investing adequate resources in children - making
the early commitments and maintaining it through the years with support from international
agencies and donors. This continues till today. For example, public expenditure on education has
increased by 110 per cent between 1997 and 2000. This is about 8 per cent of GNP, and 15
per cent of total public expenditure. About three quarters of this money is being spent on basic
education, in activities such as building new boarding schools in remote areas where girls are
deprived of educational opportunities because of the long distance to schools. Consequently,
Bhutan’s ratio of girls to boys in primary education is currently at 45:55 – a marked improvement
from 41:59 in 1991.
Health expenditures have also increased significantly in Bhutan. From about 10 per cent of total
government expenditures in 1997, Bhutan now spends 15 per cent.
Donors, World Bank, Government of India and UN have certainly played an important role in ensuring such strong commitments for human development, but these do not diminish the efforts made
by the Royal Government of Bhutan to tap new sources of revenue, such as hydroelectricity.
23
24
4
Investing in quality primary education,
particularly for girls
At the start of the 21st century, the case for investing in primary education
has been made in international forums and in the countries of South Asia.
The case is by now familiar to those who decide on the allocation of government resources,
to NGOs, civil society and communities. The case that perhaps still needs to be made,
including to families, is that this is the best investment that governments and families
can make for the welfare of their children and for the future generations. There is ample
evidence now to show that investments in primary education for all-and particularly for
girls-has long-term impacts. Literate women tend to marry later and are more likely to
use family planning methods. Life expectancy at birth rises because children with literate
parents are more likely to survive infancy. Literate workers are more productive as they
are more likely to seek ways to improve their work. Family income rises as literate parents
tend to have fewer children and are more likely to find better paying jobs.
n
n
n
n
n
n
n
n
The economic returns to primary education have been estimated by the World
Bank at over 24 per cent, much higher than many other alternate investments
Each additional year of schooling of mothers translates into a decline in child
mortality by 5-10 per cent.
Globally, it is estimated that an extra year of female schooling reduces female
fertility by 5 to 10 per cent. The lowering in the number of dependents, which is
referred to as the ‘demographic gift,’ is said to be the effect which contributed
from 1.4 to 1.9 per cent to the annual per capita growth in East Asia. In Pakistan,
18 per cent of uneducated women had discussed family planning with their
husbands, compared to 29 and 44 per cent among primary and more educated
women respectively. In India, while 42 per cent of uneducated women had
discussed birth control with their husbands, 58 per cent of primary schooled
women and 71 per cent of secondary schooled women had done so.
Children whose mothers have no formal education are twice as likely to suffer
from malnutrition as children whose mothers completed primary school.
School attendance increases for children who had participated in early childhood
programmes
Boys who attend pre-school for two years will, on average, earn about one-fifth
more as adults as their counterparts who did not benefit from such services.
Those who have experienced a caring early childhood earned 10 to 30 times more
in their adult lives compared to those who did not. Every dollar of investment in
early childhood is said to have fetched 7 times higher investment in the long
run.
Only 3.6 per cent of Bangladeshi women with no education were willing to go
alone to a local political meeting, compared to 6.6 per cent of primary educated,
18.1 per cent of secondary educated and 46.2 per cent of college educated women.
25
All governments in South Asia have recognized the importance of primary education and
have made impressive gains. However, girls still lag behind boys in attendance and
completion of primary education and it is questionable what children are learning in school.
In Sri Lanka, for example, there is a trend towards declining enrolment and attendance
and less than 20 per cent of the children are reported to reach mastery in numeracy,
literacy and life skills. In privileged schools in Madhya Pradesh State in India, 70 per
cent of grade 4 and 60 per cent of grade 5 students had not mastered basic competencies
in Hindi and Maths of grade 2 students. In Pakistan, a nation-wide sample of 11-12 year
olds reported that 64 per cent of those who had completed primary school could not read
with comprehension and over 80 per cent could not write a letter. The goal in primary
education in South Asia must be that: all children must be prepared for school, must
come to school, must stay in school in organised learning programmes, must complete
school and must achieve the basic competencies. The priority is to link communities
and schools and for parents to demand that their children ‘learn’ in school and promote
child-centered learning.
The Maldives, small islands, major strides
Investment in Primary Education and Literacy Pays Dividends
With adult literacy rate over 95 percent and universal primary education, Maldives has made steady
progress in basic education. Today, it has the highest literacy rate for men and women, highest
primary school enrollment rates and highest per capita income in South Asia. All of this is the
result of financial commitments and leadership for education spread over thirty years. At the beginning of 1970, there were merely three government primary schools in the capital Male’ and a few
private or government schools in the atolls. The outlying islands had community run or neighborhood
schools teaching the Quran and literacy. An ambitious plan to set up Atoll Education Centers and a
primary school in every inhabited island resulted in rapid expansion of primary education and UPE
within twenty five years.
In 1980, the government launched a campaign to wipe out illiteracy. The critical shortage in teachers was overcome by mobilising all civil servants and enlisting volunteers into the literacy campaign. Government ministers and community leaders regularly took literacy classes. Household surveys identified every person who needed learning assistance and literacy rates became a critical
development indicator for each community. Annual literacy awards were given to island communities that achieved highest literacy rates.
For a country that is dispersed over a thousand miles of the Indian Ocean and a small population
scattered over 200 islands this was no easy task. With strong political will and consistent financial
commitments Maldives has set an example of leadership and commitment in South Asia.
26
Primary education: large-scale successes exist in the region
Bangladesh Rural Advancement Committee (BRAC) has been providing children with non-formal education since 1985 in some of the remotest villages of Bangladesh. It has developed innovative strategies for
making education accessible to children from marginalised groups. BRAC operates over 35,000 schools in
66,000 villages, using 34,000 part-time teachers reaching over 1.2 million children. The attendance is over
95 per cent and more than 90 per cent of completors join the formal system, and learning achievements are
higher than those of children in the formal system. The key components of BRAC’s success are: community
management and ownership of schools; local recruitment of teachers, with an emphasis on females; emphasis on girls education; locally-relevant curriculum; flexible hours; cost-effectiveness; strong teacher training with an in-service component; and high parent involvement.
Pratham. Pratham was established in 1994 with a mission to achieve universal primary education in Mumbai.
It is now a network of education initiatives across 7 urban centers and 5 rural districts of India with 5000
community activists working on a daily basis with over 100,000 children. It is a platform, which brings together the local self-government, the corporate sector, and the voluntary sector.
Society for Community Support to Primary Education in Balochistan (SCSPEB). Founded in 1993,
SCSPEB unites rural communities and the government in Balochistan in a commitment to increase girls ‘
access to schooling. The challenges are formidable. Only 2 per cent of women in the province have formal
education, and girls are not encouraged to attend school due to cultural values, the dearth of female teachers and far distances to schools. SCSPEB forges a network between local communities and the state to
establish girls’ schools in rural areas. Over 1,000 schools have been established in Balochistan since its
inception. These efforts have increased the number of girls in school by more than 50 percent between
1990-1995. Quality is high with the students consistently outperforming counterparts in tests for Urdu and
Maths. The key components of its success are: mobilizing parents and supporting educational officials to
build demand for girls’ education; community provides land, identifies a teacher, and starts the school; the
government provides teacher salaries, teaching learning materials, and the funds necessary for constructing school buildings.
Emerging corporate sector investments in education. The corporate sector is increasingly expressing
and taking action to promote the opportunity for the poor and disadvantaged to access quality education.
For example, Anil Ambani of the Reliance Group of Industries in India has emphasized that the future lies in
knowledge-centred growth. At the top of this list is education and training. He has called for fundamental
reform of the education sector in India “to address many of the problems facing the country, ranging from
population control to social development”. Similarly, Azim Premji of WIPRO, through the Premji Foundation
is allocating $5 billion for primary education.
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4
Investing in health, nutrition,
water and sanitation
The foremost pursuit of human security is to ensure the well-being of
all citizens of the country. Human development begins with children.
The health and nutrition of children to ensure their survival, growth
and development is among the foremost duties and responsibilities of
parents but also of the government and the wider society.
Investments in health and nutrition have both individual and societal
returns. The immunisation revolution of the 1980s and 1990s has
demonstrated the impacts of survival on fertility, population growth, and
overall well-being of families. It has enabled an increasing in per capita
income with fewer people sharing the wealth that the nation generates
than would have been possible with high under-5 mortality rates and higher
rates of fertility and population growth. The economic impacts of good
health are by now well understood and accepted. Malnutrition, defined as
the result of poor food, health, and care, and commonly assessed by the
failure of children to grow in height and weight, is serious both in the
short and long-term. Its effects range from that on the current health
and productive activity, through to future generations.
29
The importance of investments in water and sanitation to
the health of the family and the workload of women are
now well accepted. Safe water and sanitation are
prerequisites to reducing childhood illness and malnutrition.
There has been major progress with the handpump
revolution which started in South Asia but which has now
spread to all parts of the world. Yet, sanitation lags behind
and progress is very slow. Even in access to water there
are now strains and regressions. Both the quality and
quantity of water are re-emerging as major problems in
South Asia. The approaches of the past are no longer
adequate to address the looming crisis in water.
There is a need to re-think the strategies, technologies
and approaches to providing sustainable quality drinking
water for all in South Asia.
30
Large scale successes in health, nutrition and water supply
Polio eradication. The massive polio eradication campaign launched all over the world has been a
particular challenge in South Asia to which the region has risen and responded. Global and regional support for this campaign has been provided by Rotary International. The number of polio cases across the
region has been reduced dramatically from 1485 in 1999 to 366 in 2000. India accounts for two-thirds of the
polio cases. The strategy of national immunisation days (NIDs) has borne results. The region as a whole
expects to achieve zero certification by the target date of 2005, if not earlier.
Community-based nutrition schemes. These interventions have expanded in many countries of
the region. The early successes of the Tamilnadu Integrated Nutrition Programme, beguan in 1980 was designed to reduce the incidence and prevalence of malnutrition and improve the health of children in the 0-3
age group. There was also a focus on pregnant and lactating women. Over a period of 6 years there was a
dramatic reduction of 56 per cent in severe malnutrition and an upward shift in the percentage of normal
children and very moderately malnourished children. Other community-based approaches have been developed such as the Bangladesh Integrated Nutrition Programme, the Participatory Nutrition Improvement
Programme in Sri Lanka and the Decentralised Planning for Children’s Programme in Nepal. India has had
a long-standing programme for the children in the 0-6 age group with nutritional supplementation, health,
care and education.
Vitamin A. Vitamin A is a fat-soluble substance that can be stored in the body as a reserve for a
long time to protect against Vitamin A deficiency. Universal supplementation of Vitamin A capsules is
one of the most cost-effective interventions, although dosing does not in itself address the underlying
cause of Vitamin A deficiency. However, it reduces the severity of Vitamin A deficiency. Vitamin A supplementation campaigns have been launched with the global partnership of Kiwanis, in virtually all countries of the region, in many cases on the back of NIDs for polio. In Orissa, Vitamin A has reached 75-95
per cent of the targeted under-five children and triggered campaigns in other states. Pakistan has also
achieved 95 per cent coverage and in Bangladesh over 44 million capsules were distributed in 2000.
Vitamin A supplementation is a major success story in Nepal now covering 69 out of the 75 districts
with an overall coverage of 90 per cent.
Salt iodisation. Iodine deficiency is the single most significant cause of preventable brain damage
and mental retardation. Iodine deficiency disorders (IDD) affect all stages of human growth and development, the fetus, the neonate, the child and adolescent and the adult. IDD and goitre are more common in females, especially during puberty, pregnancy and lactation. Salt iodisation is one of the most
cost-effective strategies to prevent IDD. South Asian countries committed in SAARC to eliminate IDD
by the year 2000. Progress is seen in the hilly regions of the North of South Asia but large parts of the
Northern, Middle and some Coastal states in India, Pakistan and Bangladesh have less than 50 and in
some cases 25 per cent of household consuming iodised salt.
Oral re-hydration therapy (ORT). ORT, pioneered in Bangladesh is known to be the most costeffective intervention for control of diarrhoeal diseases. Today over 93 per cent of the population is aware
of ORT in Bangladesh. ORT has spread across South Asia and in other parts of the world.
The handpump revolution. Providing drinking water to millions is one of the greatest success stories in South Asia. The handpump has allowed millions of the rural population acess to
safe water aquifers in their surroundings and saved millions of lives by reducing the consumption
of unsafe surface water. However, competition for water from the same aquifers by agriculture and
industry has increased and the demands on groundwater are surpassing the rate of recharge of
the aquifers. The demand pressure on the declining ground water table is execerbated by the contamination of ground water as a result of arsenic, fluoride, iron, and salt water intrusion. Millions of
people in South Asia are without water in the hot summer months.
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4
Breaking the silence on HIV/AIDS
The HIV/AIDS epidemic in South Asia region is diverse, localised and
has different trends over time.
At the end of 1999, more than 4 million people were already living with
HIV/AIDS, most of them in India. In Bangladesh as in a few states in
India HIV/AIDS prevalence is still low. At the same time about six states
in India are already experiencing a generalised epidemic with over 1
per cent prevalence in pregnant women. Some states in Pakistan and
Nepal have concentrated epidemics with more than 5 per cent prevalence
in sex workers and injecting drug users.
Left in silence, HIV/AIDS has the potential to become a pandemic in
South Asia as forecasted by UNAIDS. Already 23 per cent of the 5.6
million adults and children newly infected in 1999 live in Asia. In a
region where countries have such large populations, even low HIV
prevalence means that huge numbers of people live with the virus. Youth
in South Asia will be disproportionately affected by AIDS. The available
surveillance data, limited as they are, indicate that for example in India,
over 50 per cent of all new HIV infections take place among young
people below the age of 29 years. It is estimated that in India, there
are annually between 100,000 and 200,000 infected pregnancies giving
birth to approximately 30,000 infected babies.
Currently prevalence
rates in the region
are reported to be
low, the proportionate
growth is the highest
in the world.
Lessons from Africa show that if the threat of HIV/AIDS is not taken
seriously and tackled effectively, the costs of a pandemic can reduce
the countries’ economic growth. HIV/AIDS also ravages households
through the stress and costs of treatment and care of infected persons
and the upbringing of AIDS orphans. Thailand, on the other hand, is
an example of how the pandemic can be controlled. One of the first
steps is to break the silence on HIV/AIDS that exists in most
countries of the region and to focus actions to mitigate its
potentially devastating impact.
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4
Investing in eliminating worst forms of child labour
Government estimates indicate that there are about 25 million children
in the work force out of a total of 300 million children in the age group
5-14 years. The range of estimates is, however, from 25 million to 150
million depending on methodology, definitions and concepts used. The
majority of child workers are in the age group 10-14 years. The problem
is more perennial in India, Bangladesh, Pakistan and Nepal.
While poverty is a cause of child labour the issue is complex and
multifaceted. Children working as child labourers are not only denied
their right to education, play and leisure but may also be exposed to
various health hazards and abuses such as physical violence, sexual
harassment and drugs. Given the magnitude of the problem in the region
and the diversity of working girls and boys, in terms of the context and
environments in which they live, there is no quick or simple solution.
However, there are a number of experiences and efforts in the region
attempting to make a difference on a large scale from which lessons
have been learned.
Child labour is a
concrete manifestation
of violations of a range
of rights.
Large scale successes and constraints in combating child labour
M. Venkatarangaiya Foundation (MVF). The MV Foundation pioneered the “Bridge Course” where child labourers aged 9-14 years attend night school or three months residential camps to prepare for entry into the formal
education system. No economic incentives are given to the children, their families, or their employers. Instead,
children have been pulled out of labour through mass political mobilization. MVF focuses on community organizing focussed on employers and parents. MVF has reached 80,000 children aged 5-14 years from 500 villages
in Andhra Pradesh. MVF has come to the conclusion that poor parents want to send their children to school,
and that even hard-core child workers can be integrated into the mainstream education system. The Government of Andhra Pradesh has gone to scale with this initiative under the ‘back to school’ programme.
Sialkot Soccer Ball Initiative. Children made up more than 30 per cent of the 40,000 work force in this industry,
and were paid less than half the adult minimum wage. In February 1997, a joint programme for elimination and
rehabilitation of child labourers was designed in partnership with ILO, UNICEF, Save the Children (UK) and the
government. The project claims to have get approximately 5,400 children withdrawn from work; set up 154 nonformal education centres; shift 80% of production work to specially monitored stitching centers which are childlabour-free; give small microcredit to the families of ex-child workers as a compensation for the income forgone.
Bangladesh Garment Manufacturers and Exporters Association (BGMEA). In 1993, the garment industry in
Bangladesh was estimated to employ about 80,000 child workers. Following the introduction of the Harkin Bill in
the United States to ban products involving child labour, about 70,000 children were dismissed from the factories. The Government of Bangladesh, ILO, UNICEF and BGMEA made a joint effort to relieve them from their
current work and ensure that they are enrolled in school. Gono Shahjaya Sangstha (GSS) and BRAC were given
the responsibility to open schools to bring the ex-workers in. About 10,000 children were enrolled in 318 schools
whose families were given stipends to compensate them for the loss of income. Reports suggest that many of
the children dismissed from garment factories may have turned to other more harmful forms of child labour and
some may have become victims of sexual exploitation. The experience would suggest that while the policy of
getting child labourers to school is correct, the approach to tackling child labour needs careful experimentation.
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36
4
Investing in eliminating
trafficking in women and girls
The scale of trafficking in women and girls in South Asia is difficult
to estimate but there is no shortage of human stories and the
visibility of the problems in some of the large urban centers of the
region. The trafficking of women must be seen separately from the
trafficking of children. Women are unwillingly trafficked because of their
desire to escape from poverty or discrimination, from domestic violence
and abuse, from social customs which lead to their oppression in the
home, from armed conflict, for physical security and if the safety of
their children is not assured. The responses to curbing trafficking in
women have been multifaceted but the human rights lawyers have
emphasized the importance of ensuring that the human rights and
freedoms of women are not violated in an attempt to help and support
those who are trafficked. For example, the right to mobility must not
be taken away from women.
Maiti Nepal.
This is a determined fight in Nepal to deal with the problem of women’s trafficking. Anuradha Koirala, “a Mother Theresa like figure,”
started a decade ago with small personal credit to nine destitute
women. Today, her programme has special significance in high trafficking districts of Nepal. Their main thrust is in: acting as a strong
pressure group to get trafficked girls rescued from brothels in India
and elsewhere; rehabilitation of the rescued girls; raising awareness
in high trafficking areas through door-to-door counseling; formation
of local groups to identify those who brought or sold girls; and seeking police help to have those trafficking in women and girls investigated and arrested.
Trafficking in children is an altogether different problem. Children are
trafficked for a wide array of reasons. In some cases parents sell their
children to traffickers because of poverty or long practices where
daughters from some communities have traditio nally go ne into
prostitution. In most instances, however, children who are trafficked
have typically run away from their home because of violence or abuse.
Child trafficking requires draconian measures. The State must
institute preventive and deterrence measures to ensure protection
and care for those children that are trafficked. The measures must
be sensitive to the environment from which the children came in
the first place and must not put trafficked children back into
families, which abuse.
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4
Investing in reducing gender disparities
Gender inequality hampers growth and development.
Investing in gender inequality is integral to investments in all other sectors.
It requires investments to address the particular concerns of girls and women
and strategies to overcome the inherent discrimination that prevails in their
equal participation in all aspects of development and protection.
Changing attitudes and behaviour of men and boys towards women and
girls, which are formed, from the early years within the family and
community will take time but actions must be taken at multiple levels.
There is an emerging recognition of investing in men and boys as role
models and advocates for improving the lives of women and girls and
creating new modes of socialization where boys and girls are equally valued
in private and public domain. To overcome the inherent discrimination a
conscious effort needs to be made to design strategies to reduce gender
inequality such as providing life skills to adolescent boys, investing in
fathers to participate in early childhood development and valueing
educating girls and women. Emphasis has been placed on giving women
economic security, which can bring about changes in how they are valued
by their husbands and families, thereby giving them greater voice in the
family and community. This is one of the objectives in targeting credit for
self-employment activities to women. There is now also considerable
evidence of the high social returns of educating women.
n
n
n
In India, it was found that women who had completed high school
earned 1.5 times more than those without education and women
with technical training earned three times more than women with
no education. In Pakistan, women with a primary education earned
24 per cent more than those with no education, while men with
the same level of education earned only 17 per cent more than those
with no education.
One study estimates that between 0.4-0.9% of the differences in
growth rates between East Asia and Sub Saharan Africa, South Asia,
and the Middle East can be accounted for by the larger gender gaps
in education prevailing in the latter regions. Moreover, the analysis
shows that gender inequality in education prevents progress in
reducing fertility and child mortality rates, thereby compromising
progress in well-being in developing countries.
The gender gap in enrolment in China is six times lower than in
Pakistan. There are much higher chances of a child remaining
unenrolled in Pakistan if he/she is born in a low income family,
and there are more chances for his/her dropping out of school before
the primary and, furthermore, the secondary grade is completed.
“…to be a woman in this region
is to be a non-person”. Mahbub
ul Haq. Women bear the greatest burden of human deprivation
in South Asia.’ Discrimination
against South Asian women
begins at, or even before, birth;
and throughout life, it continues
in various areas, at various
levels and dimensions, ranging
from education and health to
mobility, control of resources,
and worst yet, to protection
issues such as domestic violence, rape, honour killing, acidthrowing, and stove burning.
These discriminations arise
from deep religious and cultural
issues, but they get worse
in poor economic and social
conditions.
Source: South Asia Human Development
Report, 2000
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4
The cost of investing in children is affordable.
Resource constraint is more a myth than a reality
One of the constraints to faster progress in fulfilling
the rights of all children, particularly in basic social
services is that of resources - financial, human and
organisational. Various calculations can be made on
how much it will cost to provide universal access to basic
social services. The South Asia Human Development
Report estimates that it will cost an additional US $ 8.6
billion a year over 15 years to reach the goal of universal
access for the estimated 550 million children. This
means an additional spending per child of US$ 15 per
year or 1.6% of the GDP of the countries in the region.
Currently, spending in the social sectors amounts to about
5% of GDP - from a high of 12% for Bhutan to 3% for
Pakistan. This level of spending at present levels is
inadequate or else we would have seen results faster.
How much can governments afford to spend is an issue
of priority not availability of resources. When the future
of the country is involved and the future lies in the
country’s children, there can be no greater investment
of national security concern than that made on children.
Distribution of Central Government Expenditure
(% of total, 1998)
health
35
education
defence
30
25
20
15
10
5
0
Bangladesh
Bhutan
India
Nepal
Pakistan
Sri Lanka
Source: State of the World's Children, 1999, 2000: World Bank, World Development
Indicators, 2000; UNICEF BSS Study for Bhutan, 2001
Distribution of Central Government Expenditure
(% of total, 1998)
health
education
defence
18
16
14
12
10
8
6
4
2
0
South Asia
East Asia
SSA
Source: State of the World's Children, 1999, 2000: World Bank,
World Development Indicators, 2000
Spending on defense and subsidies to loss-making enterprises compared to social sectors
n
n
n
n
n
A $943 million deal was signed by Pakistan in 1997 for three French submarines, which would have been
sufficient to provide the entire financing for achieving universal basic education over a seven-year period. The
20 Mirage fighter jets purchased from France in 1996 cost the equivalent of one year’s total spending on primary education.
A decade long Light Combat Aircraft project in India has absorbed about 1.8 billion dollars in the first half of
the 1990s. Costs have now been massively inflated by technological advances, and there is a growing view
that the plane will be militarily redundant at the point of take-off. Yet the project continues to absorb millions
of dollars each year, diverting desperately needed financial resources, which could have been used for education and health care.
An additional 1 billion dollars allocated to the defense budget in 1998 would be sufficient to construct 1m
schools and hire additional 600,000 teachers for basic education.
The South Asian governments spend incredible amounts on subsidies. For India, it is 40 per cent of the total
expenditure; for Pakistan, it is only 8 percent; and for Sri Lanka it is 20 per cent. Most often, these subsidies
never reach the poorest.
South Asia also spends tremendous amounts on subsidising loss-making enterprises. For example Nepal
spent about 2.6 per cent of its GDP in giving subsidies to loss making public enterprises. This is approximately the same level of expenditure as for its health services. If the loss making enterprises are sold off, this
would release some of the fiscal burden for the country.
41
42
The cost of not investing is huge …around 6 per
4
cent of the GDP of the region
Estimates of the costs of not investing adequate resources in the
education and health of children in South Asia are difficult to make,
but not impossible. For example, the costs of HIV/AIDs have been
estimated for Thailand and many African countries. Similar calculations
have not been attempted for South Asia but given the numbers involved
if the rising trend continues, the costs can be significant. Similarly,
the costs of illiteracy as seen in higher fertility and inadequate care of
children are not easily measurable.
However, if decision-makers consider that estimating the costs of not
investing is useful in making the case for investing in children, then
such estimates should be attempted in individual countries. The costs
can be huge. For example, a rudimentary calculation using the results
from some of the studies of the differential in earnings between primary
educated women and men compared to the uneducated ones, suggests
that the costs of illiteracy of girls and boys who do not complete primary
school may be large. Rough estimates which assume that if the illiterate
are earning the average income per capita of their respective countries,
and if literacy can increase it by amounts as suggested by some of the
studies in the region then this would indicate a current loss equivalent
to 6 per cent of GDP. More sophisticated estimates should be made to
make a stronger case with those decision-makers who decide on national
priorities in the allocation of resources.
Similarly, in Thailand the direct cost of treating the existing number of
HIV/AIDS patients has been estimated. Extrapolating from these
estimates indicates a cost equivalent to 0.2 per cent of GDP for South
Asia based on the current numbers of cases of HIV/AIDS.
Similar cost estimates can be made for other areas where actions are
needed such as in nutrition. But the two components of education,
particularly of girls and HIV/AIDs suggest that the costs of not
adequately addressing them are costing the countries of South Asia
around 6 per cent of their GDP. This translates to a loss of US$ 37
billion for South Asia per year, which is much higher than what it
would cost to invest in providing primary education for all.
Case for Investing in Children
n
n
n
n
n
Investing in children makes
good economic and social
sense.
Investing in children is of utmost national and human security interest.
Investing adequate resources
to meet the rights of each child
is a legally binding obligation
that has been accepted by all
governments of South Asia.
The resources for adequate investments in children are available - the constraints are not financial, human or organisational. The adequacy of the investments must be seen in
terms of what needs to be done
to fulfil the rights of each child.
Education is the single most effective interventions for achieving impact on all human development indicators.
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4
Actions must be taken individually and
collectively. Partnerships are essential
Close to half of the population in the nations of South Asia, who are
children under 18, will be the adult citizens in the next decade and the
next generation. As workers, they will turn the wheels of the economy;
as citizens, they will have their say in large and small decisions of the
nation; and as members of the community and the family, they will be
the actors in civil society and will decisively influence the future of the
following generation – their own children. Two-thirds of the citizens
in the year 2020 in South Asia have already been born and many of the
prospective leaders of the second half of the 21st century are now in
their early formative years. The most productive investment countries
in South Asia can make is in their children. Adequate and effective
investment in children is the essential provision for realising the
potential for becoming the “most dynamic region in the 21st century”.
There is no shortage of lessons from good and bad experiences in the
region. There is no shortage of an articulation of constraints, difficulties,
and excuses on why the region cannot move forward faster. There is
no shortage of experts and expert analysis in the region on the rate of
progress and the returns to investing in children. There is no shortage
of commitments - political and in policy documents. There is no shortage
of resources if the commitments and priorities are there. Results for
children exist in the region but yet there is neglect and there are a
large number of children yet to be reached.
The High-Level Meeting has, therefore, been convened as part of a
process to seek ideas on how progress can be accelerated for all children
early in this millennium.
Some of the areas to explore are:
n Leadership. The lessons and experiences of successes in the
region show that above all factors it is leadership that is critical
for achieving results for children. It is not the commitments
that have been made. It is not the policy documents that may
have been written. It is not the analyses and sharing of
experiences that has led to results. But it is the vision,
commitment of individuals who are in a position to influence
decisions on resource allocations and implement actions that are
critical. This leadership is required at all levels of society with
each one of them building allies with whom they can work and
the leaders working together for a common cause. The leaders
45
exist in South Asia but what is needed is a larger critical mass
of leaders who are focused on the results for children not empty
commitments and who are prepared to be judged and be held
accountable by others for the results.
n
Voice. Many voices have been raised in the cause of children; as
a result we have come this far. What is now emerging is that
children themselves have well thought out views and ideas that
deserve to be heard. Their voice is worth hearing and must be used
as a force for change for themselves and for society. Examples of
giving children a voice in holding their elders accountable exist such
as the Children’s election in Colombia, which resoundingly demanded
an end to the long-standing civil conflict in that country and Mexico,
which indicated the priorities for children. The leaders of the
countries in the region and the children themselves need to explore
how they can become a representative group whose voice can be
important in ensuring actions for the welfare of all children
particularly the marginalised and girls.
n
Mobilising additional government expenditures at all
levels. This can only be done if greater priority is given to
children and this is measured not only in terms of additional
allocations but additional results. This means that the operative
monitoring is not of government expenditures but the results
of those expenditures. This requires treating investments in the
future of children as a priority on par with that of other
investments in national security. Social sector investments must
be treated as non-discretionary expenditures and must be at a
level where they demonstrate results for all children. Tackling
inefficiency in the utilisation of the funds is important, but in
the end this must be part of the results framework not of the
framework of excuses.
46
n
Corporate sector as a partner. Many partnerships have been
explored and many partnerships exist - between communities, NGOs,
Government and international agencies. These partnerships have
proved important for results. But one as yet lightly tapped partner
is the corporate sector. Yet many in the corporate sector and private
individuals have already taken actions in their own way - some
making small strides others with much larger commitments. What
is common to all these efforts is that they are focused on results
and corporate partners want to know what works and why they
should support them. This can be the vital ingredient to larger scale
government and other national efforts if done in partnership and
with oversight and monitoring of impacts and results.
n
Civil Society and multi-sector partnerships. Civil society,
NGOs, multi-lateral and bi-lateral agencies are already in the
forefront of tackling many of the root causes which affect the
well-being of children. Lessons from many experiences around
the region and other parts of the world have shown the synergies
that can be generated by acting in partnership at the micro, meso
and macro level. These efforts need to be continued and built
on successes. Eradicating poverty and addressing gender
insensitivity is not the mandate of any one agency alone but a
collective task undertaken in partnership.
Children are the future. Investments in them must be seen as being of
utmost national and human security interest. Clearly the current rates
of investments - financial, human and organisational - by families,
communities, governments at all levels, civil society and NGOs, the
private and corporate sectors and the international partners - is not
sufficient. Acceleration is needed - but how?
The South Asia High-Level Meeting is another opportunity for sharing
ideas on how we can move forward and what needs to be done for
the children of South Asia.
47
48
4
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