Publisher Note
An earlier version of this paper was presented at the 24th Re-union of National Committees of UNICEF in Europe, Brussels, April 1978.
The views expressed in this paper are the author’s own. They do not necessarily reflect those of the Indonesian National Development Planning Agency, to which the author is an adviser.
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A PROFILE OF CHILDREN IN POOR ASIA
CHILDREN IN THE POLICY AND DEVELOPMENT PLANNING PROCESS
THE COMMUNITY BASED SERVICES APPROACH
INTRODUCTION
The preparations for the International Year of the Child 1979 inevitably bring to mind the UN Declaration of the Rights of the Child, 1959. This declaration stipulates the rights of the child to affection, love, and understanding; to adequate nutrition and medical care; to free education; to full opportunity for play and recreation; to a name and nationality; to special care, if handicapped; to be among the first to receive relief in time of disaster; to learn to be a useful member of society and to develop individual abilities; to be brought up in a spirit of peace and universal brotherhood; to enjoy these rights, regardless of race, sex, religion, color, national, or social origin
Although we all share the aspirations, and the sense of common humanity that have led to the formulation of these rights, experience in these 20 years have made clear the difficulties in trying to create the social conditions which would make these rights meaningful and applicable in situations of extreme endemic poverty.
It has made those of us involved in this endeavour realize how great the social distance is that has to be covered and how much time it is going to take before that goal is even in sight. The intractible nature of some of these problems have made many of us even more aware to what extent the needs and problems of the child are linked to a whole network of independent variables in the development process, and to what extent these linkages are affected by processes of rapid social change resulting both from high population growthrate and modernization. All this has forcefully brought home not only the importance and urgency of meeting the needs of the child in conditions of absolute poverty as a valuable goal in itself, but also as a crucial factor in determining the quality of national life, now and in the future.
Our success or failure in dealing with the needs of the child, especially among the poorest part of the population, will determine whether or not, in the poor countries in the world, we will have a permanent underclass of second-rate citizens, who never had the chance and may never have the chance fully to develop their human potential, constituting a mass of human beings stunted in their physical, mental, psychological and social development.
In the final analysis it is the quality, the health, the intelligence, the skills, the capacity for cooperation and organization in adulthood, of the children in the poor 2/3 of the world, their aspirations,their values, their hopes, but also their frustrations, their despair and their anger, which will shape our nations and the common future of humankind, in what is most likely going to be a crowded, hungry and competitive world. These may well have a greater impact than any of the projections which the futureologists of today are capable of making us believe.
In this paper I will try to discuss some of the ways in which development planners in some parts of the third world are trying to come to grips with meeting the needs of the child in the 0 - 15 years age group in conditions of multiple deprivation. It is impossible to say that we have been very successful so far, but I believe that at least the road that we have to travel is beginning to get a little clearer, after many experiments, much desillusionment and many failures.
In part these difficulties had to do with the very fundamental changes in our perception and understanding of the development process itself, and in corresponding changes in development theory. Parallel to these changes there have been shifts in the perception of the place of the child in the development process.
This paper attempts to define the place of the child in the planning process in light of some of the more recent thinking about development strategy, i.e. the community based services and the basic human needs approach to development and the fundamental societal changes implicit in that approach.
Let me begin then by sketching out the magnitude of the problem as it presents itself in the poor parts of Asia, emphasizing the situation of the child in the four most populous countries of Asia, excluding China, i.e. Bangladesh, India, Indonesia and Pakistan, although later on, in the discussion of intervention policies, I will draw on experience outside this region as well.
A PROFILE OF CHILDREN IN POOR ASIA
The total population of these countries as of 1978 is around 880 million, of which around 400 million are children below the age of fifteen. Each of these four countries have per capita national income below 225US$.
2) According to present estimates2), one-third to one-half of these children live below the poverty line. These are the children of landless, marginal farming, labour families in rural areas and children of poor families in slums and shanty towns of urban areas.
Several studies have indicated that the health, nutrition and education status of the children of these poor families is far below the status reflected in national average indicators.
Infant mortality rates in these countries vary from 90 to 150 per thousand. Mortality rate of children between one and five years of age in one of these countries is as high as 22.9 per thousand. Thus in a typical poverty situation in poor Asia around one-fourth to one fifth of the children do not survive to reach the age of five3). The high rate is directly related to the high incidence of diarrhoeal and infectious diseases, poor nutrition status of the child and poor accessibility of health services.
In Indonesia, for example, only 25 per cent of children are within the effective reach of the rural health services. The problem of high mortality is also intimately related to the high fertility rate. Total fertility rate, meaning average numbers of live births per completed family, is still as high as 6.5 in some of these countries despite the fact that family planning programs have made initial headway.
There is a widespread prevalence of malnutrition among children under five years of age. Around 30 to 40 per cent of the children suffer from mild and moderate, and three to nine per cent from severe protein - calorie malnutrition. A significantly high percentage of children also suffer from vitamin A, iron and iodine deficiencies. Besides taking a high toll of infants and pre-school children, malnutrition severely stunts the mental and physical growth of those who survive infancy and pre-school childhood.
The nutrition status of women is poor, due largely to low consumption of food and repeated pregnancy. Women often get least preference in the allocation of available food in the family. Low per capita income and lack of knowledge on maternal nutrition including false traditional beliefs about the relationship between kinds of food and pregnancy, are some of the underlying causes.
It is at this stage in our discussion that we should ask ourselves the question of the impact the development process has on the child, and what development planning really means for the child.
Can the planners help the child escape the early death trap of malnutrition cum-diarrhoeal - respiratory diseases, the most important cause of infant mortality? Can they also help him or her to face the dangers of protein, iodine and iron deficiencies which at an early age could severely cripple mental growth, threaten eye sight, and which could also lead to cretinism or simply retarded growth. Before we discuss these questions we should try to have a closer look at the growth process of the child during school age in a not untypical rural poverty situation, the environment in which the majority of the children in these countries grow up. Between the age of 8 - 10, or even earlier, depending on the level of family income, the child begins to help its parents. If it is a boy, he begins to bring food to his father or mother in the field, to tend the animals, to collect firewood, and later on to help his father in the field. In the case of a girl, she will be entrusted with the care of the younger children, sweeping the house and the yard, helping her mother in the preparation of food, and the fetching of water. It is at the end of this period that if the child goes to school, it starts dropping out. It is the time in which it moves from doing so called "enabling" work - work that enables its parents to concentrate on their main activities - to productive, income generating work4).
With the exception of Indonesia, only around one-third of the adult population is literate in these countries. While the number of children enrolled in primary school are increasing every year, the drop-out rate of children continue to be high. Only about 50 out of 100 children enrolled in grade I reach grade VI. Enrollment rates of girls in primary school continue to be lower than those for the boys.
The boy may at a later stage start working for a richer peasant, but there is little prospect of his staying at school and preparing himself for a better life, except if the income of the head of the household increases significantly. After his work, he returns to a home where the parents are often too tired to pay much attention to the children, or too much engaged in other low productive labor. He can play with the other children until it is dark, but there are no toys except those which they make themselves.
This is an environment which provides little stimulus for his cognitive development or for that of his own personality. Only if he is lucky enough to have his grandparents nearby or in the house, will he have a chance, through listening to the folk tales, the epic stories and the songs of his traditional culture, to broaden his horizon somewhat.
In such a situation how can we prevent the parents from transmitting to their children their own sense of helplessness and powerlessness towards improving their material condition? How does one weave hope into the fabric of society, and into the culture of the poor? How does one awaken resilience, initiative and resourcefulness in the bleakness of such an existence?
There is another dimension to this problem which is beginning to engage the attention of social planners.
Looking into the future, even under the best of circumstances, many poor and populous countries can be expected to have low income levels for a long time to come, while population density will continue to increase rapidly. Already now social cohesion and solidarity within the village are strained to the breaking point as a result of population pressure on limited resources.
Modernization calls forth, and needs individualization, individual initiative and inventiveness, competitiveness and drives towards acquisitions and higher productivity. Modernization and monetisation are already accelerating significantly the breakdown of traditional modes of poverty sharing, mutual help and consensual decision making in the village. At the same time it has become obvious that the only solution to the problem of rural poverty on the other hand calls for greater social solidarity and community action. Life in situations of high population density requires a greater capacity for cooperation, a greater capacity for voluntary self restraint in justice to the needs of others. And the challenge to planners is how to help bring out in the child these contradictory sets of values within an integrated personality.
CHILDREN IN THE POLICY AND DEVELOPMENT PLANNING PROCESS
What is then the state of the art in planning for the needs of children? Are the problems of children in their various stages of growth sufficiently well understood by the planners? Have there been consistent policy developments that cater to the needs of children within the framework of national development plans? Do the programs __ devised from such policies effectively meet the needs of children?
Essentially there have been several improvements in this respect since the first international conference on children and youth in development planning, held at Bellagio in April 1964.
Indeed the more recent development plans in the developing countries reflect a significant improvement in terms of the priority given to the development of human resources. In this context the strategy for the development of the child has been termed as "young human resource development" - at least in my country5). In a few countries like India there has been an official declaration of national policy for children reflecting the national concern for physical,mental and social development of children6). Bangladesh has established a "National Council for Children", including several cabinet ministers7). Yet in other countries, which have no national policy for children, sectoral policies to some extent reflect a concern for the needs of children. The policy development processes in most countries however are still based on a problem analysis of children on a sectoral basis. As a result the policies and measures so devised do not take into account the total needs of children, and need further improvement. Some existing policies for example, do pay attention to the nutrition needs of younger children, but ignore their needs of mental and social development from infancy to pre-school age. Similarly the policies may provide for legal measures to prohibit child labor, but ignore the poverty conditions of families and the economic value of their children in sustaining their livelihood.
There are two major aspects to the deficiencies inherent in this kind of planning process. Firstly,it does not encourage comprehensive studies of children as to their basic needs for growth, which take into consideration the situation of their families, neighbourhood and community environment. Secondly, the formulation of policies and the planning process is organized sectorally, paralelling the organization of the government departments, including the location of planning units. Consequently, the departments by themselves are not sufficiently tuned to identify the key priorities for the development of the child, except on a sectoral basis. The organization of the National Planning Board or Planning Commissions generally also corresponds to the sectoral departments. Usually the National Planning Board is better placed to identify the key problems of children and steer the policy development process accordingly. In practice, the social divisions of the Planning Commissions are often poorly staffed and they, instead of providing the lead to the sectors, end up by coping with sectoral operational concerns.
Thus the major attention in the policy development process given to the operational policy concerns leading to the establishment of the network for health, nutrition, education services left some of the basic policy problems unattended. These limitations of governmental capacity to provide services to all the unserved and underserved children have in recent year been highlighted in the evolution of the basic needs strategies in general and community based services for children in particular.
Before we review the community based services approach we would like to mention one other important development, namely, the attempt to cater to the needs of children in the framework of an area development approach, both in rural and urban areas. This approach has in some of our countries been evolved from the government’s desire to tackle the development problems of the poorer areas as a major policy thrust in their development plan.
Within this policy framework, and with international support, an area development approach has been evolved for the delivery of community based services for children in a convergent manner, in order that a variety of benefits can be achieved by the same children at the same time in the given areas8). The approach has three main concepts, i.e. of functional integration, spatial integration and popular participation. This approach is being tried on a pilot basis in ten rural areas and urban neighbourhoods in seven cities in Indonesia9). A similar approach is gaining some popularity in India and Bangladesh as well. The approach has positive elements in a large country like Indonesia, where the more manageable size of an area lends itself to a comprehensive analysis of the needs of children and other members of the community in that area, and which can be reflected in the overall strategy for the development of the area. At that level it is relatively easier to achieve functional integration through the formulation of integrated programs, as well as spatial integration, meaning the appropriate location of projects according to a special plan. In such a relatively micro-perspective it might be easier to establish government-community collaboration for fulfilling the needs of the community.
It should however be stated that the process of popular participation still remains to be perfected.
THE COMMUNITY BASED SERVICES APPROACH
The community based approach grew out of a realisation that most of the social services based on the older models of industrialised countries do not spread far beyond the modern sector. Many governments have already invested considerable resources in education, health and other services. They have in many cases failed to reach the majority of the children in their countries, even though it is relatively easy to determine the package of services needed to meet the basic minimum needs of the poor child and to cost it. Around 800 million children in the developing countries are either unserved or underserved with such services.
The community based services approach covering family planning, food, nutrition, environmental and community healthcare, education and housing, constitutes an attempt to get at the base of the pyramid of social services provided by the government. It aims at reaching the poorest of the poor, and especially the child and its mother among them,through the rural and poor urban communities, where most of them live. It draws on a number of relatively successful, small scale experiences in various places in the third world, centering around the family or the household. The approach is based on the principle that communities actively participate in deciding their own priorities for activities to be undertaken for them, and by them. This means community involvement in the planning process: planning from below. It is at these lower levels that the principle of convergence of various services for the same communities, should be applied. This approach implies fundamental changes in the existing system for the delivery of community based services. The wider coverage is to be attained by establishing government-community collaboration through: a) selection of workers amongst the community by the community leaders themselves and providing them simple training; b) extending the governmental administrative network by an increase of auxiliary workers, and c) re-orienting the existing government infra-structure to become supportive of community based services. The commitment of national governments is therefore essential to the success of this approach, which might itself evolve into a participatory strategy for social development, which integrates planning activities from the bottom with those from the top down.
PROBLEMS OF IMPLEMENTATION
Simple as the community based services approach and its underlying principles of convergence and community organization look, implementation has proven to be a complex and difficult affair.
Local administrators often find it impossible to justify, both in terms of their responsibility towards the population in the region as a whole, and towards their administrative superior, concentrating their programs and resources on a limited number of villages necessary in order to generate the desired synergatic effect. Also, looked at from the viewpoint of higher administrative and planning levels,the decision to which villages to give priority, requires extremely difficult political and theoretical judgements.
A persuasive case can also be made, and has been made, that such convergence, if applied at all, should be applied not to the poorest areas, but to those with a slightly higher standard of living, which are more likely to have the kind of skills and organizational capacity to make a positive response to making community based services available. Efforts at this level are therefore more likely to have secondary and tertiary effects, which would eventually benefit the poorest areas in that region.
Moreover, it has become increasingly clear that convergence, which requires on-the-ground coordination of sectoral programs, each under the jurisdiction of different ministries, is only possible with a high degree of decentralization of the governmental administrative machinery and a devolution of decisionmaking authority to the lowest possible administrative level. Decentralization in itself is a massive and complex undertaking, with great administrative and political consequences. A government may for a variety of valid reasons, be unwilling or incapable of decentralizing its administrative apparatus. In that case it would be impossible to apply, consistently or fully, the principle of convergence. It is not unlikely, however that the availability of community based services, even when not optimally applied, is bound to set in train irreversible developmental processes at the grassroots level, which over time will create a demand for such administrative reform.
One other problem that has become apparent in the implementation of the community based services approach, is not so much the intellectual acceptance of the concept by government bureaucracies, but the difficulty in bringing about, especially among local officials, the basic attitudinal shift from traditional paternalism to openness towards, and support of, emancipation and selfgenerated activity at the community level. It calls for specially designed training and retraining programs for such officials.
The uniqueness of the community based services approach lies in its foundation of community participation and village self reliance through grassroots organizations. However, despite some notable local exceptions, the history of integrated rural development and of rural institution building in many Asian countries has been marked with many failures. Under the most favourable circumstances, the process of establishing new community organizations and cooperatives, and of adapting traditional rural institutions to serve new goals, the reawakening and nurturing of community selfconfidence in its own capabilities after a long period of passive dependency and withdrawal, is bound to be long , slow and uneven. Many are the areas in Asia, for instance, where water-pumps have come into disrepair within a year after installation, and where it has remained so, because nobody had taken the time to involve the community in making the decision to have the pump installed, and in having it assume responsibility for its maintenance. And this has meant that in those villages girls and their mothers had once again to spend hours walking to get the water needed in the household. Therefore, without community interest, participation and acceptance of responsibility it is impossible to maintain the services over a long time. Even then, it will be uncertain whether such institutions will be able to develop sufficient strength to withstand the impact of the powerful economic and social forces generated by the economic development on the national level, of the modern, and generally urban sectors, thus raising the question of how integrated rural development fits into a mixed economy.
In many villages with new schools, the drop-out rate continues to show the same general pattern of reaching a peak when the children are needed for work in the field or in the household, that is after the third or fourth year.
In part this is a function of family income, but it also has to do with the often enough correct perception on the part of the parents that formal education has little relevance to the direct improvement of the material conditions of their life as a family 11). It may also in part have to do with their parents’ perception of how their life as a productive unit could best be organized, and of the economic value of their children to them in that context 12). It makes it unlikely therefore, even with a more relevant curriculum, and even if the parents could afford it because of higher income, that both children’s and parental motivation to go to school and stay there, will be adequate unless there is some community run pre-school preparation, as well as some community pressure to keep the children at school. Here again it is the manner in which the community perceives and relates to the basic facility provided, which will determine how long the service will remain an active one.
One point should be made in addition. Despite the clear and decisive importance of rural institution building, without which the services will remain lifeless alien and empty facilities within the community, government bureaucracies as well as donor agencies tend to measure performance by the number of pumps or schools or health clinics installed, because both mentally and procedurally they are not well equipped to take into account the labor-intensive and time consuming task of building viable social institutions capable of integrating those services into the dynamics of village life. They both will have to adjust to the recognition that village cooperatives, or more traditional village institutions, are an essential condition for permanent effectiveness and for the attainment of convergence, and that the time needed to nurse them towards maturity, may in the end pay off handsomely.
Even under the best circumstances, the communication problem in rural development is a formidable one. There is quite often a wide gap between the felt needs and aspirations at the village level and the assessment of local priorities on the part of administrators and planners at higher administrative levels. The community based services approach especially requires new or improved mechanisms for dialogue and interaction - in short, for mutual education - and above all, on the part of planners and administrators a greater capacity and willingness to listen respectfully.
Experience in the supply of community based services also shows that those services are only sustainable among the poor if family income increases sufficiently. Employment and income generating policies on the part of the central government are an essential precondition for the success of the community based services approach. In many Asian countries the child labour force constitutes at least four and one half per cent pf the total labour force. Unless family income rises to the point that they can afford draught cattle the child will be doomed to labor much of the time in the field, assisting his father and mother, or another farmer. Increased income therefore means less child labor as well as less mother-labor, and therefore more opportunities for improved child care, and better food and nutrition especially for the younger children.
One of the community based services related areas which on the whole have not received adequate attention of social planners - with the possible exception of health - and family planning volunteers - is the joint government-community selection and training of community based volunteers for the delivery of basic services, and the development of areawide systems of such volunteers. Field experience in all the countries under discussion has shown the importance of locating training centers in the village, and not in the city, in which the teachingstaff stays in the countryside and shares in all aspects of rural life. Motivation and identification with the interests of the poorest in the village, on the part of the trainees, and their capacity to motivate others to organize for community action, have turned to be as important as the acquisition of skills13). Many questions however remain open.
To what extent for instance are, and should, community based volunteers be exchangeable among different communities in the same, or in different areas? How can the experience of volunteers in one community be made supportive of similar efforts in other communities?
Should planners envisage one or two multipurpose volunteers in a community, or several singlepurpose ones? And should they operate on the basis of sharing the poverty of the community, or should they be renumerated - and could they be, without destroying their effectiveness or their credibility, and if so, at what level?
Most likely, local conditions and pressures will dictate the response to these questions, although cost, learning capacity and the availability or absence of effective communication linkages with the outside world, are bound to affect choice as well.
Many of the countries under discussion have had for some time also urban based volunteer organizations of some kind, for rural development. Their effectiveness has proven to be quite mixed. In their role as changeagents, such volunteers have on the whole become useful adjuncts to the village headman, assisting him in the implementation of developmental projects of various kinds. Still, many have remained "outsiders" to the villagers. The community based services approach now provides an opportunity to them for an expanded and even quite different role in integrated rural development. These volunteers could for instance make a significant contribution to the development of new and to the adjustment of traditional community organizations and institutions, and by identifying new opportunities which they could utilise. In addition, almost all governmental rural development programs provide new opportunities and accord new rights to the villager, including the poorest ones. It would be desirable in this light, to enlarge the mandate given to such volunteers towards actively promoting the interests of the villagers by helping them to avail themselves of such opportunities and to exercise their rights under such programs.
Conceivably, such efforts could be undertaken also by high summer school volunteers through programs, at the university level through study service programs, and by the women’s movement.
THE BASIC HUMAN NEEDS APPROACH, COMMUNITY BASED SERVICES AND THEIR NATIONAL POLICY IMPLICATIONS
Some of the experiences in developing community based services at the grassroots level related earlier, make it obvious that such services are unlikely to retain their viability unless they are supported by a more general basic human needs approach to development. We all know that such an approach grew out of the search for a developmental strategy which could deal more effectively with the problem of continuing poverty in large parts of the world. Within the limited timespan of 25 - 30 years, it is now hoped that such a strategy will be able to reverse the trend of growing inequality in developing societies, which threatens to leave the poorest 20% of the world population permanently in conditions of absolute poverty. The basic needs approach constitutes a direct attack on world poverty by meeting the essential needs in the fields of food, nutrition, family planning, community and environmental health, education and housing, as well as through employment and income generating activities among the lowest 40% income groups. In a recent paper "National
Policy Implications of the Basic Needs Model" I have discussed the policym packages which would be required in these fields. They need no further elaboration here .
15) A number of development theorists and planners would like the basic human needs approach to set minimum goals which in their view, are now already within reach for the more advanced developing countries and which should set the standards to be reached or surpassed by all of mankind:
- life expectancy of 65 years or more, as compared with
- the present average of 48 in the low income countries.
- infant mortality of 50 or less per 1.000 births compared
- with 125 now.
- literacy rate to be at least 75 per cent compared with
- 33 now.
Minimum rates of progress should furthermore be formulated in terms of:
- food production and distribution
- per capita incomes and equity
To be useful in guiding the implementation process, basic needs must, in their view, be expressed in clear and specific terms. That process itself must make the fullest possible use of presently under-utilised human and physical resources. In that way, it will not only lead to improved employment, but also generate the resources for a self-sustaining approach towards fulfilling basic needs.
The basic human needs approach is predicated on a policy package consisting of a relatively high growth rate (6-8%), redistribution of income, and - up to a point - wealth, reorientation of investment, and a review of consumption and production patterns. It is hoped that such a thrust, with the rural sector and labor as major factors in productivity increase, will lead to processes of internally generated development, which over time, could develop into an indigenous engine of growth.
MACRO POLICY FRAMEWORK
Both the community based services and the basic human needs approach require an appropriate macro policy framework for development. This should include the adoption of employment and equity as development goals of equal importance as growth. It also means the determination of multiple growth goals, a commitment to development from the bottom up, to local self-reliance, community and grassroots organization and participation in planning, decision making and implementation in areas affecting those communities.
Such a macro policy framework should in addition cover a major shift of development resources to the rural areas, and especially to the poorest among them; it should include land-reform policy; price policy for food stuffs leading to increased production and at the same time ensuring improved calorie and protein intake of the children of the poorest in both the rural and the urban sectors; policies which redress the traditional imbalance between town and countryside in favor of the rural areas; progressive taxation; reduction of differences in consumption patterns between the modern and the rural sector; an industrial policy which give priority to labor intensive industries which can be located in rural areas. These policies and others, governing technology choices, energy policies, and research, should be embedded in a set of national policies regarding human settlements,the planning for which should encompass the whole of the national territory. Such a macro policy framework entails a major redistribution of economic and political power, that is bound to be extremely painful and risky. Any government that wants to commit itself to the basic needs approach and the provision of basic services, will have to calculate very carefully how much strain the prevailing political system can take without breaking up, or without being overthrown. No outside party can make that kind of judgement, and outside leverage on this kind of a decision is bound to be insignificant. The commitment to community based services has to have a firm foundation among the political public, before the appropriate transitional policies can be effectively implemented. While the emplacement of community based services should not wait for this to happen, it would be foolish to underestimate the implications for the essentially political character of the commitment, and the complex processes that will have to be gone through before the community based services can exert their full impact.
The effort to meet basic needs obviously also requires an unprecedented inflow of information into the village, capable of reaching the poorest villagers as well. It is unlikely that the amount of information a farmer or a housemother would need to adjust to social change and opportunities, could effectively be transmitted through the usual channels of communication15): the village headman, the extension services and the educational system. What is essentially called for is the transformation of the village from a traditional to an information society, capable of acting and responding creatively to relevant information reaching it, capable also of reaching out for that information. Apart from village level wallnewspapers, the communications breakthrough that is needed may well require special programs on TV, radio and cassettes directed at the villagers, but at the same time produced with their participation, and responsive to their needs and aspirations.
FOCUS ON THE CHILD
Where does this discussion lead us in relation to the care and development of the child in the world of the poor? It is obvious, one, that to date, there is no better alternative to the community based services approach, and, two, that the delivery of such services directed to the child cannot stand in isolation. It has to be part of a more general attack on poverty through a basic human needs approach to development, involving major structural societal changes. These complex changes will have to be brought about along a broad front and will, contrary to earlier expectations, take time. Moreover, these changes will most likely only have their desired effects, if a series of equally difficult structural changes are made, simultaneously, in the industrial countries, as well as in the international system. Obviously, we cannot wait for all this to happen first.
Our problem therefore is to maintain in the meantime a firm and constant focus on the child and its needs over a timespan of at least 15 years, i.e. the duration of 3 consecutive five years plans. Such a focus should make it possible for us to persist, despite all the difficulties, in developing community based services in the areas of health care and nutrition supplementation in order to help bring down the high infant mortality rate and to reduce the incidence of developmental retardation resulting from severe proteincalorie malnutrition (PCM). Nutrition supplementation could also reduce the incidence of impairment in the development of the central nervous system which apparently results from the interaction of PCM with iodine deficiency. Combined with iron deficiency this may be a major cause for the low capacity of the multiply deprived child to interact with its environment, an essential precondition for its cognitive development17).
The apathy, withdrawal, low response to environmental stimulus and poor attention maintenance, characteristic of severely malnourished children, often also resulting in reduced reciprocal mother-child interaction, all leading towards developmental retardation, point to the need for early childhood education and stimulation programs13), in addition to health care and nutrition supplementation.
The demand for such intervention program is bound to grow as a result of the social structure of poverty itself19): high population growth rate, the socio-economic distribution of population growth, in which fertility is inversely related to family income; the urbanisation process in which most of the newcomers from rural areas settle in urban slums; and the necessity for women to earn or supplement family income through work outside the household.
A number of Latin American countries, and also some African, have undertaken early intervention programs to prevent cognitive deficiencies resulting from environmental conditions, mostly using existing infrastructure with, usually, centre based programs, aimed at disadvantaged children from age 0 to 5. Hard nosed evaluation of such programs has just begun20), but the limited provisional impressions that are available suggest that very few of them have managed effectively to reach the child in the poorest regions, or to affect more than marginally the cognitive and personality development of the children, or in changing nutritional practices and the fertility rates of parents. Based on the same impressionistic evidence, it seems that non-governmental community-run child care centres on a small scale have been somewhat more successful, although the cost benefit ratio seems to be such that it prevents replication at the national level at acceptable cost.
Even though these programs are clearly still in the experimental stage, they are unquestionably of great significance, not only to the countries concerned, but to the third world at large. More experimentation and more external support for such experiments are obviously very much in order.
In many studies on differences in child development among the poor, the importance of home stimulation of the child, the quality and the quantity of social, emotional and cognitive stimulation and support available to the young child in the home and the role of the mother within it, emerges quite forcefully. Some analysts tend to look at the mother as the prime factor in the stimulation of the child towards upward mobility21). Observations like these raise the question whether any early education intervention system could be more effective and cheaper than programs directed at the mothers. Such programs should cover the development of labor saving methods22) in the preparation of food and in doing domestic chores, giving her more time to interact with her children; through producing a simple child rearing manual23) or cassettes, which could help to combat traditional harmful practices as well as reinforce useful cultural traditions, while giving instruction into the ways in which parents help provide the early stimulation towards the cognitive and social development of the child. Supporting such efforts should be the production of materials for child care through the mass media, and the development of cheap,locally produceable toys, but also making available more widely and cheaply, folktales, myths and new children’s stories which could provide meaningful linkages both with the modern world and the traditional one. It is obvious that such mother oriented child stimulation programs require the support of competent volunteer services both at the community and at the national level.
Without prejudice to the importance of the father’s role in childrearing, or that of the family, it can be said that the crucial developmental importance of the role of the mother24) makes it absolutely essential that the income and employment generating policies under the basic human needs strategy are quite deliberately made to apply with equal force to income earning female heads and members of households as well . By the same token, special care should be taken that basic needs programs do not work to the disadvantage of women, either in terms of work opportunity or earning capacity. It also raises questions about how family instability25), and the high divorce rate among the poor, affect her role in the cognitive and social development of the child. This question applies with even greater force to urban situations where mothers, either as head of the household or not, can no longer fall back on the support of the extended family system. In general, how to enable women to play their role as mothers in meeting the needs of her children, without pushing her back into a traditional subordinate role in the household, or without hampering the development of her full potential as a human being, is still a constant challenge facing planners, and is bound to remain one for a long time26).
These efforts to reach the child through community based services should of course be supplemented by policies which deal with child work and child exploitation. The claims on child labor in poor rural areas could be reduced by income generating policies for the head of the household, and through providing alternative sources of animal or mechanical power in order to enable the working child to go to school. School hours could be adjusted to a period late in the day27), or to non-formal methods which takes education and skill training to the child at work. Patterns of extreme child exploitation in industry, prostitution and child trade are especially found in some urban settings. Legal injunctions are usually not effective, and policies will have to be developed which provide alternative forms of employment and income for the child, or alternative income for the head of the household.
Industry-by-industry studies could suggest ways of how to develop opportunities for a better future for children working in such enterprises, while maintaining their contribution to family-income, through programs of out-ofschool education and measures which could help prevent their work from jeopardizing their health and future growth. Also, through appropriate formulae for costsharing among the enterprise involved, government and the mother, childcare facilities for children with mothers working in enterprises or doing manual labor, could be greatly expanded28). It would seem that a sufficient number of promising experiments in various countries now makes that a feasible goal.
The socialisation of children in conditions of rapid social change, constitute another set of problems which require a great deal more research and study before meaningful policies can be developed. Piaget has made some important observations concerning the age in which a child becomes capable of cooperation, because he becomes capable of differentiating other people’s points of view from his own29). But we still don’t know which factors turn one child of poverty into a violent thug and the other into a person with social concern and compassion. Our efforts to reach the poor child has deepened our awareness how little we really know about the child. To what extent have we fallen victim in this regard to the general fragmentation of our conception of the human being and the cycles of his life, which has resulted from the fragmentation of science itself into mutually incommunicable disciplines ?
Development involves modification of traditional cognitive styles, attitudes, values and beliefs. It also involves changes in parental goals and expectations, as well as in child rearing methods30). These changes in perceptions and values do not only affect the family unit, but has also a broader significance. Each culture and each nation, especially in the developing world will have to develop its own general philosophies about what attitudes and values are to be inculcated or to be brought out in the child’s development, and about how these relate to broader social development processes. It is going to be of great importance that in doing so we do not fall into manipulative, technocratic, or totalitarian techniques and that we develop ways in which the freedom and autonomy of the adult into which the child will grow, will remain secure. What helps in this connection may well be our incapacity to prepare for the future in rapidly changing societies in any set and preconceived way. The best preparation for that future may well lie in the fullest development of a child’s creative capacities, and not in any synthetic perception of the human person and his place in society.
There is a need for a new conceptualization of the role of the child in poor developing countries, and of how its needs are affected by that role. It is only then that we will begin to have an idea of what its needs are and how these could be met. Such a conceptualization will have to start from the recognition that in such countries the majority of the children into work-enabling and then increasingly, productive work - from the age of 8 - 10, and that they carry a variety of responsibilities, like taking care of their young brothers and sisters, of older people and even sometimes of one or both of their parents. This runs counter to the concept of childhood as a separate and protected period in a person’s life, characterized by immaturity and incapacity of judgement.
All programs aiming at meeting the needs of the child in the poor developing countries, be it nutrition supplementation, health care, early cognitive stimulation, education or play, should be designed around the actual social and economic roles of the child. Additionally, special programs should be devised which would help strengthen the child’s capacity to play that role, without harm to its own health, to its potential for growth and to its basic rights. Such programs should aim at developing the child’s self confidence and self respect, its sense of autonomy, and at developing the childrens capacity for self organization and mutual help31).
Therefore, in light of the very limited and fragmentary character of our present knowledge of the total needs of the child throughout infancy and childhood, we can only develop a comprehensive policy framework for the child with a great deal more research, experimentation, evaluation and adjustment. There is also a need for a much greater capacity for policy analysis regarding the child in poor countries. This requires periodic comprehensive analysis of the situation of the children. In a large country this analysis should be undertaken at the subnational/area level to identify the priority needs of children in less-developed areas.
There is also a need to deal with the basic policy problems arising from such a comprehensive analysis, side by side with ongoing analysis of operational policies affecting children.
Finally there is a need to establish a policy development unit either in the national Planning Board/National Planning Commissions or in an independent national research institute. The function of this unit could be to formulate the national policies for children and continuously monitoring the same; to review the various national policies affecting the children; to review the programs for children; and lastly to advise the national government on further development and implementation of policies for children, including the identification of projects that are financially, socially, and administratively feasible in the shortterm.
One final remark. The magnitude of the problem before us - 800 million children in the Third World, of which 400 million in poor Asia alone - forces those of us, who are involved either in planning or administering programs to meet the needs of these children, to reduce the child to its statistical aspects. It is the only way we know that has at least a chance to do justice to the staggering quantitative dimensions of the problem. But in our efforts to bring down infant and child mortality rates we tend to shield ourselves from, and to ignore, the psychological and physical cost these figures imply, and the heartbreak to the mother and the family. In developing health and educational programs for the child, we are inclined to overlook that each child is unique, and a world unto itself, in the process of becoming an adult person who will have to find himself in order to be capable of relating creatively to his environment, and with understanding, sincerity and goodwill,to other persons. Our awareness that for all our efforts we are incapable of drawing those human dimensions into the purview of our work, and to infuse it with the love that is each child’s birthright, should make us humble indeed. But even at the level of trying to help meet the most elementary needs of the child, as this paper makes clear, our knowledge is still woefully inadequate, the weaknesses of our programs only too clear. Still, we will have to keep on trying, for we can only find better answers by doing. And the children cannot wait.
Jakarta, May 29, 1978.
FOOTNOTES
1. UN General Assembly Resolution 1386 (XIV) November 20,1959. Source: I.Y.C. Report No. 9, April 1978.
2. Statistical Profiles of Children and Mothers - prepared by UNICEF Country Offices in Dacca, New Delhi, Jakarta and Islamabad.
"CHILDREN IN ASIA 1977"
"STATISTICAL PROFILE OF CHILDREN AND MOTHERS IN INDONESIA" (Profil statistik Anak dan Ibu di Indonesia). United Nations Children’s Fund (UNICEF), Jakarta, November 1977.
3. "POLA KEMATIAN DI JAWA DAN IMPLIKASINYA PADA KEBIJAKSANAAN KESEHATAN RAKYAT DALAM PELITA III". by. John E. Rohde, Terrence H. Hull and Lukas Hendrata. In Prisma, Indonesian Journal of Social and Economic Affairs, No. 1, February 1978. pp. 64 - 76.
"DUNIA KANAK-KANAK: LANGITNYA BERKABUT" by Masri Singarimbun. In: Prisma, Indonesian Journal of Social and Economic Affairs, No. 11, November 1977, Jakarta.
4. Studies in Indonesia and Bangladesh have shown that around the age of 14, the value of the child’s work begins to exceed the very low cost of its upbringing.
See: "THE ECONOMIC IMPORTANCE OF CHILDREN IN A JAVANESE VILLAGE" by Benjamin White. Reprinted from: David J. Banks (ed.), Changing Identities in Modern Southeast Asia. The Hague, Mouton, World Anthropology Series, 1976, pp. 269 - 290.
"PRODUCTION AND REPRODUCTION IN A JAVANESE VILLAGE" by Dr. Benjamin N.F. White, Ph.D. Dissertation, Department of Anthropology, Columbia University, New York 1976.
"VALUES AND COSTS OF CHILDREN TO JAVANESE AND SUNDANESE PARENTS: PRELIMINARY RESULTS FROM THE INDONESIAN V.O.C. SURVEY" (Nilei anak dan beban terhadap orang tua: hasil sementara penelitian pada masyarakat Jawa dan Sunda) by. Dr. Masri Singarimbun and Paul Meyer M.A. Seminar paper, Yogyakarta, April 1977. For publication in Prisma.
"THE ECONOMIC ACTIVITIES OF CHILDREN IN A VILLAGE IN BANGLADESH" by. Mead T. Cain. In: Population and Development Review, Volume 3 number 3, September 1977.
5. REPELITA II (Second Five Year Plan)
"PENGEMBANGAN SUMBER DAYA MANUSIA USIA MUDA: POKOK-POKOK PERMASALAHANNYA DI INDONESIA" by. Soelaeman Soemardi and S. Mursyid. Published in Prisma, Indonesian Journal of Social and Economic Affairs, No.5, Jakerta, October 1973.
6. Such a policy has been established in India at the National Institute of Public Cooperation and Child Development.
7. There is also a Children’s Academy in Dacca.
8. "A SHORT NOTE ON AREA/REGIONAL DEVELOPMENT STUDIES IN INDONESIA". Paper published by the Directorate of City and Regional Planning, Directorate General of Housing, Building, Planning and Urban Development, Department of Public Works and Electric Power, Jakarta, January 1978.
"PENGEMBANGAN AREA" Published by Departemen PUTL-Direktorat Tata Kota & Tata Daerah-Proyek Studi Pengembangan Sosial untuk Perencanaan Daerah & Kota - Bekerjaseana dengan UNICEF, Tahun ketiga, Nomor 5, January 1978.
9. These areas are - West Pasaman (West Sumatra), Way Abung (Lampung), Indrameyu (West Java), Grobogen (Central Java), Gunung Kidul (Special District of Yogyakarta), Madura (East Java), Taburana - 3 districts, Tabanan, Buleleng, Jembrana (Bali), South/Central Lombok (West Nusatenggara), Takalar/Goa (South Sulawesi), and South Kendari (South East Sulawesi). The cities referred to are: Cirebon, Yogyakarta, Bandung, Semarang, Surabaya, Medan, and Ujung Pandang.
10."A STRATEGY FOR BASIC SERVICES" UNICEF.
11. Masri Singarimbun, op.cit.
13. In Gonoshasthaya Kendra and BRAC, Bangladesh, all centre personnel, including the director start the day, after morning prayers,with two hours work in the ricefields.
14. "NATIONAL POLICY IMPLICATIONS OF THE BASIC NEEDS MODEL" by Soedjatmoko. Paper prepared for Seminar on: Implications of the Basic Needs Model, The Mague, February 24, 1978. Published by Prisma , Indonesian Journal of Social and Economic Affairs (English Edition) No.9, 1978, Jakarta.
15. "THE DECLARATION OF AMSTERDAM". The Amsterdam Symposium on Food and Basic Needs. Center for World Food Studies and Netherlands Committee for a New International Order. Amsterdam, March 1, 1978.
16. See also: "NUTRITION, HEALTH, AND POPULATION IN STRATEGIES FOR RURAL DEVELOPMENT" by Bruce F. Johnston and Anthony J. Meyer, Stanford University. In: Economic Development and Cultural Change, October, 1977. pp. 19 - 21, on the communications aspect.
17. "ADVERSE SOCIAL AND BIOLOGICAL INFLUENCES ON EARLY DEVELOPMENT" by Henry N. Ricciuti. To appear in H. McGurk et al. (Eds), Ecological Factors in Human Development. Amsterdam: North Holland, Chapter 12.
18. "KEBUTUHAN POKOK ANAK-ANAK YANG TERLUPAKAN" by Saparinah Sadli. In: Priema, Indonesian Journal of Social and Economic Affairs, No.11, November 1977, Jakarta.
19. For these observations the author is indebted to Messrs. Richard M. Krasno and Robert G. Myers, of the Ford Foundation.
20. An important review of early childhood problems and intervention programs in Latin America is being conducted by Ernesto Pollitt, sponsored by the Ford Foundation. Several observations in this section are based on an early draft of that review.
21. "THE CHILD IN THE FAMILY" by Jerome Kagan. In: The Family, DAEDALUS, Journal of the American Academy of Arts and Sciences, Spring 1977, pp. 4750.
"RESEARCH ON WOMEN: "APPLIED" and "ACADEMIC" Paper by Hanna Papanek. (Draft)
22. "EASING THE BURDEN OF RURAL WOMEN, A 16 HOUR WORKDAY" by Richard M. Fagley. In: Assignment Children, No. 36, UNICEF, October/December 1976. pp. 9 - 28.
23.8.9.Dr.S.Othman’s guide for mothers in Oman.
24. "THE ROLE OF WOMEN IN CONTRIBUTING TO FAMILY INCOME IN INDONESIA" by Dr. Augustien Saksono. Friedrich - Cbert - Stiftung. The Role of Women in Contribution to Family Income - Proceedings of the regional workshop in Bangkok, 19 - 23 July 1976. (Published in 1977).
"BENGALI VILLAGE WOMEN AS MEDIATORS OF SOCIAL CHANGE" by Florence E. McCarthy. In: Human Organization, Vol. 36, No. 4, Winter 1977.
25. "DEVELOPMENT AND DISINTEGRATION OF THE FAMILY" by Irene Tinker. In: Assignment Children, No. 36, UNICEF, October/December 1976. pp. 29 - 37.
26. "WOMEN AND NATIONAL DEVELOPMENT: THE COMPLEXITIES OF CHANGE". DEVELOPMENT PLANNING FOR WOMEN. by Hanna Papanek. In: Signs, Journal of women in culture and society, Vol. 3, No. 1, Autumn 1977. pp. 14 - 21.
"THE DEVELOPMENT APPROACH TO LIBERATION: SUGGESTIONS FOR PLANNING" by Erskine Childers. In: Women and World Development, pp. 129 - 137. Edited by Irene Tinker and Michele Bo Bramsen, Overseas Development Council, Washington D.C.1976.
27. e.g. The Tilonia project, Rajasthan, India: a school run by local people late in the day.
28. "LES CRÉCHES MOBILES EN INDE" by Meera Mahadevan. In: Assignment Children, No. 40, UNICEF, October/December 1977. pp. 68 - 86.
29. "SIX PSYCHOLOGICAL STUDIES" by Jean Piaget. New York: Vintage Books, 1967. pp. 29 - 39. Quoted in "Comparative Human Rights" by Richard P. Claude, John Hopkins University Press 1976. p. 318.
30. "ECONOMIC SYSTEMS, CHILD REARING PRACTICES AND PERSONALITY DEVELOPMENT" by Conrad M. Kozak. In: American Journal of Economics & Sociology, January 1978, Volume 37, No.1. pp. 20 - 22.
"CHILDREN OF THE DISPOSSESSED"
by Barry Nurcombe. A Culture Learning Institute Monograph. East-West Center. The University Press Hawaii, 1976, pp. 207 - 209.
31. The author is indebted for this insight to Dr. Elise Boulding. See her forthcoming, seminal book: Children’s Rights and the Cycles of Life.
APPENDIX
The aquivalent figures for Indonesia are as follows:
The total population of Indonesia for 1978 is projected at around 141.6 million, of which around 61.4 million are children below the age of fifteen1).
According to official estimates around one third of these children live below the poverty line2).
Infant mortality rate is estimated at 130 per thousand. Mortality rate of children below five years of age is as high as 20.7 per thousand3).
In Indonesia, only 25 per cent of children are within the effective reach of the rural health centres4):
fortunately, total fertility rate, meaning average numbers of live births per completed family, has declined in Java from 5.5 in 1971 to 4.2 in 1976, a drop of 20 per cent. The National Family Planning Program, which began in 1970 and enjoys strong political backing and support from major religious and other private organizations, is believed to be an important reason for the fertility decline. However, total fertility rate in the outer islands, at 6.8 in 1971 – well above that of Java – has showed no decline up to 19765). Around 30 per cent of the children suffer from mild and moderate protein-calorie malnutrition and three per cent from severe protein-calorie malnutrition6).
Only about 31 out of 100 children enrolled in grade I reach grade VI7).
FOOTNOTES OF APPENDIX
1. UNICEF: "Statistical Profile of Children and mothers in Indonesia.
2. Presidential Speech, August 1977.
3. R.H. Pardoko: "Health Status in Indonesia - As assessed in 1975".
4. Speech by the Minister of Health to Rakernas meeting - January 1978.
5. IBRD : "Indonesia, Recent Developments, Short-term prospects and development issues" - April 26,1978.