Poor Indian mothers braving all odds

India is also one of the 10 countries of the world with the deepest “survival divide” between poor and wealthy urban children, in the same category as Rwanda, Kenya, Ghana and Nigeria

London: Urban India is a tough place for poor mothers and their children. That has been made horrifyingly obvious in the Mothers’ Index, a global study released earlier this week ranking the well-being of the world’s women and children. India ranks a poor No 140 in the 179-country list, three places down from last year’s index.

More than half of the country’s poor urban children are stunted, compared to 20 per cent or less of its wealthiest. India is also one of the 10 countries of the world with the deepest “survival divide” between poor and wealthy urban children, in the same category as Rwanda, Kenya, Ghana and Nigeria.

The index is contained in The State of the World’s Mothers: The Urban Disadvantage, a report commissioned by the NGO Save The Children that makes clear what social observers have always suspected: a slum is among the worst places in the world in which to be a mother. Dr Margaret Chan, Director-General of World Health Organisation, in her foreword to the report, mentions, “diets are poor,” she said. “Diseases are rife.

Pregnancies occur too early in life and too often. Good health care, especially preventive care is rare…These are the women and children left behind by this century’s spectacular socio-economic advances…Their plight is largely invisible.” Significantly, the report also links inequality in urban areas with the health of its poorest women and children, a relationship rarely deliberated upon. Developed countries with minimal inequality in their populations rank high up in the world’s Mothers’ Index.

Norway, Finland, Sweden, Australia are among the top ten. Among India’s neighbours, Bangladesh is ranked 130 while Pakistan is 149. By way of comparison, the United States of America is ranked 33rd while China is placed at 61. The key findings of the report are that inequality is worsening in many cities; the poorest children face alarmingly high risks of death in most cities; the poorest urban mothers (and children) are deprived of affordable healthcare; their high death rates are rooted in disadvantage, deprivation and discrimination.

It would be a mistake for the government to dismiss the report. These findings are a wake-up call in a rapidly urbanising India in which the poor and the slums they live in are being glossed over by official policies driven by business-friendly compulsions and big-ticket infrastructure projects. But these policies are leaving the India’s urban poor at a distinct disadvantage. The five fast urbanising states – Tamil Nadu, Maharashtra, Gujarat, Punjab and Karnataka – will soon have more than half of their populations living in cities. These states already account for more than half of the country’s slum population.

That inequality in urban areas is on the rise has been well-documented. The Gini coefficient – an internationally accepted measure of inequality in which zero is perfect equality and 1 is perfect inequality – for urban India increased from 0.37 to 0.38 in five years from 2004-’05 to 2009-’10, according to a study by the erstwhile Planning Commission. For all the talk of re-housing slum-dwellers and the homeless, India’s slum population has been growing at a disturbing pace.

It more than doubled in ten years, rising from 43 million in 2001 to more than 93 million in 2011, according to the government data. And it was projected to grow every year. It means inequality has hardened. In the slums and make-shift homes on pavements, it is the women who bear the brunt of the lopsided economic system. “Among the poorest 20% of women in New Delhi, only 27% receive recommended prenatal care and only 19% have a skilled attendant at birth,” it says.

In slums across Mumbai, Delhi and other Indian cities, all indicators of pre-natal, delivery and post-natal care were consistently worse in slum areas than in non-slum areas, according to National Family Health Survey 3. It found that almost 45% of children under age five in Mumbai and 41% in Delhi slums were stunted. These facts demonstrate that all boats have not been lifted by the rising economic tide.