Tamil Nadu has been one of the best performers with regard to reduction in fertility rates and a large number of indicators of women’s and children’s well being like IMR, MR, Nutrition, schooling, etc. While Kerala has had an advantage of good social indicators over a long time frame, Tamil Nadu is a better example for other states as it demonstrates that even with high poverty ratios, large population, and poor nutrition statistics, etc, it is possible to improve the performance in a short span of only a few decades. Some of the factors identified to explain the improved performance are as follows:
Female Age at Marriage has risen significantly in Tamil Nadu. This has been possible due to a strong social awareness programme created by a popular reformer called “Periyar” Ramaswamy (EVR) whose influence was felt all over Tamil Nadu, particularly by people of the poorer strata. Periyar emphasised the need to ‘liberate women from frequent delivery by the use of contraception’ and ‘not to allow marriage of a woman before 22, so that 3 to 4 births could be averted’. The initial push given by Periyar for raising the age at marriage continues to be given support by the Tamil Nadu government. Welfare schemes for girls provide grants if girls complete 8th/10th Standard of education and marry after the age of 20. The amount is forfeited if either condition is not fulfilled. The Chief Minister’s Noon Meal Programme launched in 1982 all over the State (It covered some areas in Kamaraj’s time), has given a tremendous boost for health, welfare and for the acceptance of the small family norm. It was launched against administrative advice as it was expected to be very expensive, involving Rs. 100 croes, at 85000 feeding centres, for 85 lakh children in the 2-15 age group, requiring 2 lakh additional staff, and huge logistic issue of supplies. MGR’s pushed the scheme. He said – “When hunger haunted my home a lady next door extended to us a bowl of rice, and saved us from 88 extinction….Today as CM it is my duty t provide at least one meal to every child every day, to eliminate the agony of their helpless mothers.” Expected and unexpected benefits of the Noon Meal programme have been many. It is a crèche for the 2-5 age kids; school attendance has improved and drop out reduced; child nutrition has improved; Centres serve as immunization/ antenatal care/ supplemental feed centres for 6 month to 2 year children covered under TINP; provides employment for about 2,00,000 women, mostly widows and destitutes, as mid day meal organisers. These women helped carrying the health message to the poorest households as they came from that social background. Provided an all women focus. Serious efforts at raising female literacy and status. Kamaraj in 1961 introduced the concept of one school for every village. Assistance for education up to Class– VII is provided by the State by free education, mid – day meal, free textbooks, one set of uniforms, one set of chappals, and free bus pass. Since 1987, assignment for Government land both for cultivation and for house site is issued only for women. Commission for women established in 1993 to go into issues concerning women; Schemes for marriage assistance, nutritional support for pregnant women, grants for widow remarriage, and special schemes for girl child are there in Tamil Nadu. Improvement in IMR reduction and Child Survival has also been on account of intensive training of ANMs, establishment of Rural Health training Centres in selected PHCs to provide such training, creation of new post of Chief Health Nurse to monitor all MCH activities in a Block, special training of dais in antenatal care, provision of Disposable Delivery Kits (DDKs), adoption of fixed day schedules for ANMs (Mondays for antenatal care, Tuesday for review meetings in the PHC, Wednesday for immunisation, Thursday for School Health Programme, Friday for IEC activities for expectant mothers. Acceptance of Contraception and Birth Spacing is another feature in Tamil Nadu. Sterilization has been a very high priority for Collectors. At the district level, most Collectors roped in the entire resources and manpower at their disposal for the family welfare programme. A large part of the success of Tamil Nadu in reducing Crude Birth Rates from 1984 onwards can also be attributed to the very effective IEC programes – many messages emphasised – small family, spacing, age at marriage, ideal weight of the new born child , etc. Recent studies point out a number of enabling factors that have facilitated Tamil Nadu’s rapid demographic transition. Commonly cited factors include a good infrastructure, a rich history of social reform movements, high literacy rates in the younger age groups, wide popular exposure to mass media, and strong ‘political will’. Less widely discussed is the relatively liberated status of women in contemporary Tamil society. Tamil Nadu has a high female – male ratio, little gender bias in school attendance, and high levels of female labour force participation. Also interesting is some recent information from the second round of the national Family Health Survey (1998-99) relating to different aspects of ‘female autonomy’. Whether we look at the proportion of adult women who work outside the household (43 percent), or who have independent access to money (79 percent), or who are able ‘to go to the market without permission’ from other family members (79 percent again), Tamil Nadu is ahead of all other major states (with one exception – Himachal Pradesh – in the case of independent access to money). Bearing in mind the role of women’s agency in the demographic transition, this feature of gender relations is crucial to our understanding of what happened in Tamil Nadu. Study on Tamil Nadu contains a wealth of insights into the practical, day – to- day measures that have helped to enhance the quality of health services in Tamil Nadu. To illustrate: primary health care centers in Tamil Nadu are well supplied with basic drugs; about 40 to 45 percent of medical officers or women; ANMs meet the Medical officer typicall six times a month; many primary health centers ( more than 250) are open 24 hours a day. In all these respects, the situation in Tamil Nadu contrasts quite sharply with the situation in most other States.Category Tamil Nadu National Average
Female Literacy 64.55 54.16
Decennial growth
in population 11.19 21.34
School Attendance
6-17 age 79.7 72.1
Infant Mortality Rate 48.2 67.6
12-23 month children
who have received all
vaccinations 88.8 42.0
No comments:
Post a Comment