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SOCIAL WELFARE NUTRITION 15.9.1 The nutritional status of a nation has close relationship with other indicators like the extent of economic growth, food adequacy and its effective distribution, levels of poverty, status of women, rate of population growth, and access to health, education, safe drinking water, environmental sanitation, hygiene and other social services. A multi-sectoral approach is, therefore, required to tackle the problem of malnutrition and other associated disorders. 15.9.2 In the earlier plans, malnutrition was perceived mainly as a problem of poverty due to which large numbers of the poor could not afford a 'balanced diet'. Ignorance about health and nutrition and frequent episodes of infections due to nutrition-related deficiencies were reconised as associated, as well as aggravating, factors. The importance of raising the purchasing power, increasing production of cereals, pulses, milk, eggs and green vegetables and their consumption, therefore, received attention. Vulnerability of children and pregnant and nursing mothers was recognised. The range of direct interventions expanded over the years to cover supplementary feeding of children and mothers, production of nutritious foods, fortification of foods and of salt, nutrition and health education of mothers, and prophylaxis programmes against identified nutritional deficiencies. In the Fifth Plan, supplementary feeding programmes were brought under the Minimum Needs Programme (MNP). Supplementary feeding also became a component of ICDS. Substantial increase in allocations for poverty alleviation programmes in the Sixth Plan was visualised as a means to increase the purchasing power of the rural poor and enhance food intake. Larger coverage of vulnerable sections of the population through public distribution system, expansion of health and other social services to reach the poor and increased coverage of specific programmes to tackle problems of nutritional deficiencies were other measures expected to raise the nutritional status of the population. Review of Performance 15.10.1 In the Seventh Plan, programmes of poverty alleviation, population control, increased production of cereals, pulses, etc and expansion of social services, particularly health, water supply and housing, were expected to have an impact on the nutritional status of the population. Special programmes were implemented in different sectors for improving nutritional status through a combination of direct measures covering nutrition education and extension; development and promotion of nutritious foods;fortification and enrichment of foods; supplementary feeding; and prophylaxis programmes. 15.10.2 Nutrition education and extension activities were strengthened. A network of 34 Mobile Food and Nutrition Extension Units (MEUs) of the Ministry of Food imparted education on nutritive value of different foods and on how to choose a balanced diet through live demonstrations supported by lectures, film, slide shows and exhibitions. In the Seventh Plan, 6,633 training courses, covering 135,839 trainees were organised. In 1990-91, 870 courses were organised covering 22,671 trainees. Four Food Processing and Nutrition Centres in rural areas provided demonstration/training in the processing of fruits and vegetables at home level and nutrition education. The Integrated Nutrition Education Scheme was launched in 1988 to equip grass-root-level workers of different departments with basic knowledge on food, nutrition and health, Under this programme, 210 education camps/orientation training courses were organised in the Seventh Plan for anganwadi workers, multipurpose workers, auxiliary nurse midwives (ANM), lady health visitors, health education and adult education instructors and gram sevi-kas. The number of such courses organised in 1990-91 was 81. 15.10.3 In the area of development and promotion of nutritious foods, over 12.7 million litres ot'Miltone (a milk-like beverage based on 50 per cent groundnut protein and 50 per cent animal milk suitably enriched with vitamins and minerals) were produced. Five Ready-To-Eat (RTE) food plants produced 105,198 tonnes of extruded foods from cereals and pulses/oilseeds enriched with vitamins and minerals. About 73,673 tonnes of extruded energy food (non-extruded), a blend of cereal and pulse/oilseed flour, fortified with certain vitamins and minerals and sweetened with sugar or jaggery was produced in four energy food plants of the Government for the supplementary feeding programmes. 15.10.4 The scheme of fortification of milk with vitamin A was extended to 45 cooperative dairies in the country in 1990-91 from only 5 in 1985-86. About 3.35 million litres of milk were fortified with vitamin A daily in these dairies in 1990-91. 15.10.5 The fortification of salt with iron, to tackle the problem of iron deficiency anaemia, was continued in the plants in Tamil Nadu and Rajasthan. For the national goitre control programme, the production of iodised salt was stepped up from 7.72 lakh tonnes in 1986-87 to 22.56 lakh tonnes in 1989-90, through public and private sector units. Eighteen States/Union Territories completely banned the sale of non-iodised salt. Resurveys done to assess the impact of the goitre control programme indicated the effectiveness of iodised salt in controlling goitre/iodine deficiency diseases. Some States decided to distribute iodised salt through the public distribution system. 15.10.6 A major programme of direct nutrition intervention was the Supplementary Nutrition Programme introduced in 1970-71. It aims at providing 300 calories with 10-12 g of protein to children below 6 years for 300 days in a year. Pregnant women and nursing mothers are provided 500. calories with 15-20 g of protein for 300 days a year. Coverage under SNP which was 11.57 million at the beginning of the Seventh Plan increased to 22.9 million at the end of the Plan. 15.10.7 The programme of Mid-Day Meals (MDM) for school going children initiated in the States in 1962-63 is meant for 6-11 year age group. Under the programme, supplementary food providing 300 calories and 8-12 g of protein per child is given for 200 days a year. Coverage of children under this scheme increased from 17.1 million at the beginning of the Seventh Plan to 21.1 million in 1989-90. In several States, supplementary feeding was assisted by food supplies from Co-operation for American Relief Everywhere (CARE) and World Food Programme (WFP). 15.10.8 A wheat-based supplementary nutrition programme for pro-school children and nursing and expectant mothers was introduced in January 1986. The programme followed the norms of the existing Special Nutrition Programme (SNP). It covered 3.3 million beneficiaries by the end of the Seventh Plan. 15.10.9 Several studies of SNP and MDM have brought out certain drawbacks in implementation of the supplementary feeding programmes in regard to supply of food, discontinuity of feeding, pilferage and lack of community participation. The programme also suffered because several States found it difficult to provide adequate funds on a sustained basis for these programmes. As a result, less than the prescribed quantity of food and for fewer days was being provided. Even though there was a recognition of the need for an integrated approach, convergence of supportive health and other services in areas not covered by ICDS projects did not take place. 15.10.10 In the health sector, too, some nutriton intervention programmes were implemented. For prophylaxis against nutritional anaemia of mothers and children, a daily dose of iron and folic acid was given for a period of 100 days. In 1989-90, 19.5 million women and 21.7 minion children were beneficiaries of this programme as compared to only 8.38 million wol.n,:-"! and 6 million children in 1977-78. Evaluation of the programme by the Indian Council of Medical Research (ICMR) listed several drawbacks. These related to insufficient coverage of beneficiaries, poor quality of tablets resulting in low bioavailability of iron, non-distribution of full course of supplements to the beneficiaries and poor knowledge of anaemia among the functionaries and the beneficiaries. A prophylaxis programme against blindness due to vitamin A deficiency was carried out, under which vitamin A was given to about 38 million children in 1-5 years age group in 1989-90. There were shortcomings in the implementation of the programme in regard to coverage of children from high risk groups. These related to irregular administration of the dose, method of dispensing, poor knowledge about the programme among functionaries, low community awareness and poor extension approach. 15.10.11 Nutrition and health education was stepped up through inputs in the school curriculum, training courses of medical and allied health professional and other field level functionaries, use of mass, folk and nonformal communication media, the maternity and child services network and specific programmes like ICDS. Nutritional needs of pregnant and nursing mothers and of pre-school children constituted the core of the messages. Current Situation 15.11.1 Data on trends in nutritional status of children, women and other disadvantaged segments of the population are unfortunately not available. It is, therefore, difficult to make a precise statement on this subject in the absence of national level data. However, some inferences can be drawn from the studies carried out in some centres. Surveys by the National Nutrition Monitoring Bureau in 8 States showed,that the prevalence of 'severe' and 'moderate,'* degrees of malnutrition among children based'on Gomez classification has declined, while the proportion of 'normal' children has increased. Data on nutritional status from ICDS project areas based on age-for-weight records of preschool children showed a significant increase in the percentage of children of normal and grade I nutritional status and a decline in the percentage of children in grades II, III and IV nutritional status. However, in a large number of slum areas and poor rural areas, only about one-third to two-fifths of the children were found to have normal nutritional status. 15.11.2 Various studies have shown that nearly one-third of infants are of low birth weight (less than 2.5 kg), largely attributable to poor maternal health and nutrition status. The incidence of anaemia among children of low income groups is reportedly high. Nutritional anaemia, mainly due to iron deficiency, therefore, continues to be a major public health problem among women in the reproductive age, especially during pregnancy and adolescence. Prevalence of anaemia, as reported by an ICMR Task Force (1989), does not appear to have declined during the last three decades. Nearly 88 per cent of pregnant women were estimated to be anaemic. This is a cause for concern since the status of maternal nutrition determines the course of intra-uterine growth and development of the foetus, the birth weight of the infant, the lactation performance of the mother, and growth and development of the infants. 15.11.3 Vitamin A deficiency, especially among pre-school children from low income groups in backward, drought-prone and hill areas is still a problem. Incidence of Kera-tomalacia, an important cause of nutritional blindness, is reported to have declined and, according to some experts, is no longer a major public health problem as it once was. The national survey of blindness (1986-89) by the Government of India indicated that the prevalence rate of vitamin A deficiency in children 0-6 years was 6.54 per cent in rural areas and 4.77 per cent in urban areas. 15.11.4 There are other disorders like goitre. In India, nearly 54 million persons suffer from goitre and 167 million are living in the known endemic areas. Lathyrism is noticed in areas where kesari dal is consumed especially amonglandless farm labourers. Flourosis is found in regions with high flouride content in drinking water. Eighth Plan Strategy 15.12.1 A major objective in the Eighth Plan will be to bring about an overall improvement in the nutritional status of the population. Since the major dietary problem leading to malnutrition is more of inadequacy of calories in the diet than of proteins, the overall strategy will he to bridge the calorie gap among various segments of the population. This will, to a large extent, depend on the success of the poverty alleviation and other developmental programmes in raising the incomes and consequently, the purchasing power of the people. In addition, nutrition education and access to different food items which provide the nutritional balance must be given priority. 15.12.2 The future strategy needs to emphasise the value of diversification and improvement of diets. Increased production of cereals and pulses, green leafy vegetables, fruits, eggs, fish, milk and their availability at an affordable price are important. The crop pattern in agriculture must reflect cognisance of the nutrition needs of Indian diets. The public distribution system needs to focus on areas and categories of the population most affected by price fluctuations in the market. Strict implementation of the Prevention of Food Adulteration Act will also be necessary so that the nutritive value of foods is not affected. Direct nutrition intervention programmes will need to focus on children below 6 years of age, adolescent girls, pregnant and nursing mothers belonging to the lower income groups, Scheduled Castes and Scheduled Tribes and those living in the drought prone areas, backward areas, hill areas and urban slums. Special attention will be given to tackle the-nutritional problems of anaemia, vitamin A deficiency, goitre, lathyrism and flourosis. 15.12.3 Over-consumption of fats, salt, sugar and rich foods by the affluent sections needs to he discouraged through nutrition education. The designing of appropriate messages for prevention of obesity, coronary heart diseases, hypertension and diabetes would be necessary. 15.12.4 There are certain area-specific nutritional problems. In Madhya Pradesh, Bihar, Uttar Pradesh and Andhra Pradesh, Lathyrism is prevalent in certain pockets. The cultivation of Lathyrus will need to be discouraged, although research efforts have also been intensified to produce cultivars without the neurotoxic agents in Lathyrus Sativa. In certain parts of the country, where tluoride content exceeds 4 ppm in water, Fluorosis is a problem. Ways of providing sate drinking water needs to be explored in such regions. The goitre control programme, based on iodine fortification of common salt, will be carried out more effectively by preventing the entry of non-fortified salt into the endemic regions and ensuring the supply of iodised salt through the public distribution system. 15.12.5 A massive effort will be made to educate the community on nutrition needs and the ways of meeting them at an affordable cost. 15.12.6 Nutrition programmes will not make much impact on nutrition/health status unless some inter-related factors are simultaneously or concurrently taken care of. Control of infections, (particularly parasitic infestations) and gastro-intestinal disorders would be essential, specially in case of children. Availability and use of sate drinking water is a must for preventing water-borne diseases. The unhygienic habits of the people like washing soiled clothes and utensils near the source of water supply is a major cause of contamination of water. Basic water filteration techniques are not observed in rural areas. Therefore, education of the community on consumption of safe water and keeping the environment clean would be necessary to improve health and hygiene. 15.12.7 Programmes in the area of nutrition have not succeeded to the desired extent due to apathy and lack of community participation. People perceive these as Governmental programmes, not of immediate relevance to them, specially since the benefits of preventive programmes do not have high visibility. Unless the community is involved in the process of planning of these programmes right from the inception, it would be difficult to enlist their participation. Hence, considerable emphasis will be given to community involvement and participation of local level voluntary organisations and panchayati raj institutions. Programmes: Supplementary Nutrition Programme 15.13.1 The supplementary nutrition feeding programme for children below 6 years of age was primarily targetted in the Seventh Plan at the ICDS project areas though, in some States, beneficiaries outside the ICDS areas also received supplementary nutrition. In the Eighth Plan, with the opening of more the ICDS projects, most of the SNP programmes will be carried out in the ICDS project areas, as the convergence of services in these projects produces a much greater impact. Care will he taken to ensure that the full nutritional norm of supplementary feeding is observed, food is provided for all the 300 days, children below three years are duly covered and pregnant and nursing mothers and malnourished children get the food according to the higher prescribed norm. The mid-day meal programme will be continued in the States. Efforts will be made to involve the community in the implementation and monitoring of supplementary feeding to check pilfering and other forms of abuse. Nutrient Supplementation Programme 15.13.2 The existing national programmes relating to nutrient supplementation with iron and folic acid to prevent nutritional anaemia, Vitamin A solution to prevent blindness, iodised salt to control goitre in the endemic areas and iron fortified salt to combat iron deficiency particularly among children and women, will be continued. Production and distribution of fortified salt will be streamlined. Low-cost salt fortification technology will be developed and the possibility of double fortification of salt with both iron and iodine and their distribution in areas where both anaemia and goitre are prevalent will be explored. Distribution of iron and folic acid and Vitamin A supplements through ICDS infrastructure will be further strengthened. Programme of fortification of milk with vitamin A will be geared up to expand production capacities of the existing dairy units and cover additional dairies in the cooperative sector. Education and Extension 15.13.3 Health and nutrition education needs to be taken up on a large scale through the infrastructure of academic institutions, training institutions, industrial establishments and the mass media. Nutrition education would focus onnutrition management, nutritional rehabilitation of malnourished children, food safety, environmental sanitation and hygiene and safe drinking water. Prevention of food adulteration has to be given high importance in the scheme of nutrition education, so that people become more aware about the quality of food they consume. Village level functionaries will be given orientation in nutrition education through condensed courses and short refresher courses. 15.13.4 An important objective of nutrition education would be to bring about changes in feeding and cooking practices, especially relating to pregnant women, nursing mothers and infants. Mass media, folk media and non-formal channels of communication will he utilised to project messages, which take into account the dietary habits, local availability of food and local beliefs associated with avoidance and intake of foods. Exhibitions on nutrition and health needs will be organised in backward rural and tribal areas. The socio-cultural bias in the intra-family distribution of food in a manner which adversely affects the girl children and women, will be tackled through nutrition education and other programmes which focus on the development of women. Research and Evaluation 15.13.5 Surveys on the dietary habits of different segments of the population and surveillance data on nutritional status and deficiency disorders will be necessary to ascertain the trends. It would also be necessary to develop reliable indicators and new techniques/instruments for identification and measurement of nutritional deficiencies for field application. Assessment of the impact of various ongoing schemes would be made. Research in the development of low-cost nutritious foods using locally available materials would be encouraged as various supplementary nutrition programmes have expanded rapidly during the last decade. This would be supplemented by further research for evolving suitable processed foods for therapeutic and weaning diets with the help of Central Food Technology Research Institute (CFTRI), the National Institute of Nutrition and other institutions. Research on cereals with high protein content, pulses, and oilseeds will be encouraged to ensure increase in their production and improve per capita availability. 15.13.6 Modernisation has tended to erode traditional breast-feeding and weaning practices. The consumption of commercial baby foods is increasing. Breast feeding and home made nutritious inexpensive weaning food recipes will be promoted. 15.13.7 Institutions will be encouraged to take up research on food adulteration and quality control. Experimental fortification of foods with various vitamins and minerals will be supported for evolving suitable cost-effective and replicable methods for solving the problems of deficiency disorders. Monitoring 15.13.8 The administrative set-up at the Centre and in the States would be strengthened by inducting expertise from the disciplines of nutrition, community health and social sciences in order to enhance the technical capability in the programme implementation and monitoring. Concerted efforts would he made to achieve coordination among various departments at the field level. 15.13.9 Absence of an effective machinery for coordination of policies and programmes implemented by different departments which have a bearing on nutrition has been a great handicap. It will be desirable to set up a body, preferably a high-powered Nutrition Council, at the national level, to facilitate development of an integrated food and nutrition policy and its monitoring. Such a body will also be responsible for nutrition surveillance of the country's population, with special reference to the vulnerable groups. The body should have not only the representatives of different departments hut also experts from different disciplines. At the State level, too, a high powered coordination body will be necessary. OTHER WELFARE PROGRAMMES 15.14.1 The process of development brings to the fore problems of desertion and family disintegration due to changes in values and institutions, which provide a safety net to the physically and socially handicapped in the community. New problems, such as drug abuse, have grown at an uncomfortable pace, wtele other problems such as beggary and immoral traffic in women and girls continue to persist. 15.14.2 The earlier Plans had made a modest beginning in the designing and implementation of programmes for the welfare of the destitute, the handicapped, the elderly and other categories in need of welfare services. Among the initiatives taken were the constitution of a National Advisory Council for the Education of the Handicapped in the Ministry of Education in 1955 and a Training Centre for the Adult Blind at Dehradun in 1950. A programme of old-age pension was started in some States for the elderly without any means or support. Several States enacted legislations in the area of social defence (beggary, probation, juvenile delinquency and suppression of immoral traffic) and organised services, both within and outside the statutory framework. Education and training institutions were also started. 15.14.3 For the welfare of the handicapped, a major programme was the grant of scholarships to the physically handicapped on the basis of means-cum-merit test. Among the other initiatives were special employment exchanges for the placement of the handicapped and reservation of 3 per cent seats for the handicapped in Central Government and public sector undertakings in Group C and D posts. The observance of the International Year of Disabled Persons in 1981 gave a fillip to the expansion of services throughout the country. A number of concessions were extended to the handicapped both by the Central and the State Governments in the matter of employment, travel, etc. National institutes were set up for different categories of the handicapped. Among other programmes were integrated education of the handicapped in normal schools, training of the handicapped in vocational rehabilitation centres and apprenticeship training programmes and setting up of district rehabilitation centres. 15.14.4 The World Assembly on Aging held in 1982 provided an occasion to assess the changed social scenario for the care of the aged and to initiate programmes for their well-being. Programmes were implemented for the welfare and rehabilitation of the widowed and women in distress and in the area of social defence. Review of the Seventh Plan and Annual Plans 1990-92 15.15.1 The Seventh Plan and Annual Plans (1990-92) saw a significant expansion of programmes and services for the welfare of the handicapped in different sectors. The eradication of small pox, the extensive coverage of infants under the immunisation programme and the prophylaxis programme against vitamin 'A' deficiency, iodine deficiency and anaemia are expected to reduce significantly the incidence of handicap in early childhood. The extensive network of primary health care and the hospital-based curative services will also play their role in the identification of handicaps, treatment and cure. 15.15.2 For the education of the handicapped, almost all the States implemented programmes to provide stipends and other incentives to the handicapped at the elementary school stage. The Central Government continued the scheme to award scholarships to physically handicapped students to pursue general, technical and professional courses from class IX onwards on the basis of a means-cum-merit test. In 1990-91,about 50,000 scholarships were awarded. The programme of integrated education of the handicapped covered about 28,000 disabled children in 1990 in about 6,000 schools through the creation of special facilities in normal schools, the training of teachers and production of special instructional material. Education of the handicapped was also facilitated through special schools in different States. Some States started pre-school education programmes for the handicapped children. 15.15.3 Vocational training facilities for the handicapped were expanded in the Seventh Plan through grants to voluntary organisations and institutions run by the Government. In 1990, 17 vocational rehabilitation centres were functioning in the country, of which two were exclusively for women. To facilitate speedy rehabilitation of the handicapped, seven skill training workshops were set up. Rehabilitation services were also extended to the handicapped living in rural areas through rural camps and extension centres. Until December 1990, 5,965 blind, 7,420 deaf and dumb, 47,111 orthopaedi-cally handicapped and 1,046 persons with other handicaps were rehabilitated. Physically handicapped persons were benefitted under the apprenticeship training scheme implemented by the Ministry of Labour (DGET). For instance,565 physically handicapped persons received training in different trades in 1990. 15.15.4 The District Rehabilitation Centres (DRC), established in the Sixth Plan, consolidated their services to the handicapped relating to medical intervention and surgical restoration, fitment of aids and appliances, therapeutical assistance, vocational training and assistance in job placement. To provide technical support to the eleven DRCs, four Regional Rehabilitation Training Centres (RRTC) were set up for developing the training material and the manuals and for producing material to create community awareness through the use of different media. The RRTCs conducted full-time training programmes for the field-level functionaries and conducted management courses in disability rehabilitation. The programme of DRCs was evaluated by the Indian Institute of Management. The restructuring of the programme is under consideration for reducing the staff strength and for making the services more cost-effective. 15.15.5 In the process of rehabilitation, employment in gainful activity assumes considerable importance. A number of States have programmes for giving margin money and subsidies to the disabled and arranging loans for them through banks to facilitate their self-employment. Some States have set up training-cum-production workshops for the disabled. Andhra Pradesh has set up a Corporation for the rehabilitation of the handicapped, which provides training, gives assistance for income-generating projects and undertakes various other activities like printing books in Braille, running a lending library for the visually handicapped, etc. The placement of the handicapped in jobs in the open market was arranged through normal employment exchanges, 23 special employment exchanges and 55 special cells in the normal employment exchanges. During the ten-year period 1981-90, 63,310 physically handicapped persons were found placement, of whom 88 per cent were orthopaedically handicapped, 6 per cent blind, 5 per cent deaf and dumb and less than 1 per cent having other handicaps. The number of physically handicapped persons on the live register of employment exchanges was 2,95,838 in 1990, as compared to 1,15,982 in 1981 showing a significant increase. A National Job Development Centre was set up at the Spas-tics Society for India, Bombay as a pilot project the rehabilitation of persons between 18 and 45 years of age with disabilities like cerebral palsy, muscular dystrophy, paraplegia, etc. 15.15.6 The four National Institutes, one each for a major area of disability, set up in the earlier plans, offered a wide range of services in the Seventh Plan in the field of education, training of manpower, vocational guidance, counselling, research, rehabilitation and development of low-cost rehabilitation aids. They also functioned as documentation and information centres in the respective areas of disability. Two other organisations, viz., the Institute for the Physically Handicapped (Delhi) and the National Institute of Rehabilitation, Training and Research (Cuttack) also offered their services for the rehabilitation of the handicapped and organised manpower training. During the Seventh Plan and the following two Annual Plans, an expenditure of about Rs 63.8 crores was incurred on these six institutes. A National Information Centre on Disability and Rehabilitation was set up for dissemination of information on disability and related services. It is now functioning as a national resource centre. A Rehabilitation Technology Centre was set up in 1987 with assistance from the National Institute on Disability and Rehabilitation Research, Washington, USA to provide technology support to the programmes of the handicapped, including development of aids and appliances, their standardisation, research and related activities. Work was initiated to set up a Spinal Injury Centre at Delhi with financial assistance from Italy. 15.15.7 A Science and Technology Project in the Mission Mode on Application of Technology for the Welfare and Rehabilitation of the Handicapped was launched in 1988. About 21 projects have been funded in different areas of disabilities. These cover development and utilisation of suitable cost-effective aids and appliances and methods of education and skill development of the disabled. 15.15.8 The scheme of assistance to voluntary organisations for providing aids and appliances to the handicapped was expanded during the Seventh Plan, when grants to the tune ofRs 16.60 crores were given. Voluntary organisations were also assisted to provide services to the physically handicapped in the areas of education, training and rehabilitation. In the Seventh Plan, Rs 6.67 crores were released to voluntary organisations under the scheme. 15.15.9 For the care of the elderly, the most important welfare measure was the scheme of the old-age pension to those without any means or support. By the end of the Seventh Plan, all the States and Union Territories had old-age pension schemes, the extent of coverage depending upon the resources of the State. In 1988, 49.16 lakh persons, constituting about 9 per cent of the population above 60 years, were receiving old-age pension from the State Governments/Union Territory administrations. The rates of pension varied from Rs 60 to Rs 100 per month. The Central Government operated a scheme under which grants were given to voluntary organisations for a wide range of institutional and non-institutional services. In the Seventh Plan, Rs 136.73 lakhs were given as grant-in-aid. The Scheme received encouraging response and in 1990-91, grants-in-aid of Rs 85.58 lakhs were given to 93 organisations. Some of the States, too, assisted voluntary organisations to set up old age homes. 15.15.10 The problem of drug abuse received attention in the Seventh Plan — both the control and the welfare aspects. The Drug and Psy-chotropic Substances Act of 1985 was amended in 1988 to make the law stringent for more effective control over narcotic drugs and psy-chotropic substances. Subsequently, the Prevention of Illicit Traffic in Narcotic Drugs and Psychotropic Substances Act (1988) was passed, which provided for preventive detention of persons trafficking in drugs. The enforcement machinery was also strengthened. Voluntary organisations were assisted in creating awareness about the ill-effects of drug abuse and providing de-addiction, counselling and rehabilitation services to the drug addicts. Training of functionaries was also organised. In 1990, 112 counselling and 44 de-addiction centres, supported by the Ministry of Welfare, were functioning in the country. Community-based de- addiction camps were also organised and ten after-care centres set up. 15.15.11 Several States implemented special programmes for poor widowed women. While the older among them, without any means of support, received maintenance allowances, for the others, education, training and employmentprogrammes were organised, including residential care for those without shelter. Short-stay home facilities were organised for women in distress. Assistance for remarriage of widows was also provided. 15.15.12 For preventing and checking trafficking in women, the Suppression of Immoral Traffic in Women and Girls Act of 1956 was drastically amended in 1986 and renamed as The Immoral Traffic (Prevention) Act. It widened the scope of the Act and made the penal provisions more stringent. Services such as reception centres, protection homes, State homes and corrective institutions were organised, as required under the Act and also outside the statutory framework. 15.15.13 Beggary prevention, control and rehabilitation programmes were implemented by the States, as provided under their respective anti-beggary legislation. Some services were, however, outside the statutory framework. This was a low priority area. The services were not only inadequate but hardly made any dent on the problem. Current Situation 15.16.1 The disabled constitute an important group for welfare services. Estimates of the number of disabled vary depending on the definitions, the methodology and the extent of use of scientific instruments in identifying and measuring the degree of disability. 15.16.2 The National Sample Survey Organisation (NSSO) conducted in 1981 a countrywide survey covering three types of disabilities i.e., visual, communication and locomotor disabilities. It identified 12 million persons having at least one or the other disability constituting about 1.8 per cent of the estimated total population. About 10 per cent of these physically disabled were reported to have more than one type of disability. Considering each type of disability separately, those having locomotor disabilities were estimated at 5.43 million, followed by those with visual disabilities (3.47 million), hearing disabilities (3.02 million) and speech disabilities (1.75 million). The prevalence of disability was higher in the rural yeas (about 8] per cent). A more recent national survey on blindness, conducted during 1986-89 under the aegis of the Ministry of Health and Family Welfare and WHO, estimated 12 million blind persons as against only 3.47 million estimated by the NSSO survey. 15.16.3 Mental handicap was excluded from the NSSO survey. Hence, no reliable data regarding the size of the mentally handicapped are available. However, on the basis of some random sample surveys undertaken in Bombay, Calcutta, Delhi, Lucknow, Mysore and Nagpur and from the World Health Organisation reports, the number of mentally retarded is assessed to be 3 to 4 per cent of the country's total population. 15.16.4 The number of leprosy affected persons is estimated to be about 4 million, of whom about one-fifth are children. About 15 to 20 per cent cases are with deformities. In 196 districts in the country, the prevalence rate is more than 5 per 1000 persons. About 430 million persons live in these high endemic districts. 15.16.5 The incidence of disability differs by social class, ecological regions and occupational categories. Poverty, malnutrition, ignorance, poor environmental sanitation and hygiene and poor access to prevention and treatment programmes are responsible for the high prevalence rate of the handicapped population. 15.16.6 Industrialisation, urbanisation, increased mobility, changes in life styles and values of the young and shortage of accommodation in cities have made the elderly a vulnerable group, specially because of the decline of traditional support systems. Due to longer life expectancy, there will be a steady increase in the number, as well as proportion, of the aged as is the trend in other countries. By the turn of the century, 7.6 per cent of the population is projected to be above sixty years and in view of the large demographic base, the number will be phenomenal — about 76 million in 2001. The bulk of this population will be from the low income groups, without any independent means of support as they do not own any productive assets. 15.16.7 Drug abuse is emerging as a major problem, complicated by the emergence of powerful crime syndicates. It now affects all segments of the population, including adolescents and youth. Illicit trafficking in drugs is nowviewed as a major public concern. Although national estimates on the incidence of drug abuse are not available, statistics of law enforcement agencies, treatment centres and voluntary organisations working in this area show a rising trend. 15.16.8 The problem of beggary has remained unresolved. Its unmitigated presence in cities, towns and places ofpilgrimmage indicate that the anti-beggary legislations of States have not succeeded in tackling the problem. The enforcement machinery is weak and the services inadequate. Prostitution, the worst form of exploitation and abuse of women, continues in various overt and covert forms. The rehabilitation of eunuchs in alternate modes of livelihood also demands attention. Eighth Plan Strategy and Programmes 15.17.1 Services for the physically handicapped require integration and coordination, covering the entire range of activities from prevention of handicap to rehabilitation. Programmes under different sectors of the Plan, more particularly, health, nutrition, education, science and technology, employment and welfare have to integrate their operations in such a manner that effective inter-sectoral support develops. 15.17.2 The main thrust of the policy will be to make as many handicapped persons as possible active, self-dependent and productive members of the nation through opportunities for education, vocational training and economic rehabilitation. Voluntary organisations, which have played a key role in the organisation of services for the handicapped, will continue to be given encouragement and support. The existing services would be reviewed and suitably upgraded in terms of physical structure and training in order to make them more effective. Services should be increasingly community-based. Wherever required, the training programmes would be modified and diversified to make them relevant to available job opportunities. Emphasis will be on the promotion of programmes in the rural areas. 15.17.3 The programmes for the elderly will be both developmental and humanitarian. Their experience and energies will be utilised for societal well-being. Community and family-based welfare services will be developed for the Welfare of the Aged 15.17.10 The coverage of elderly persons without any means of support will be expanded through the schemes of old- age pensions of the State Governments. The main thrust of the programmes for the elderly will be non-institutional services which are family and community based. Financial assistance wil! be given to voluntary agencies to provide not only care but also help improve the incomes of the elderly besides involving them closely in the activities of the community so that they are not marginalised. Social Defence 15.17.11 Inspite of the existing anti-beggary legislations, the problem of beggary persists. Measures would be taken for the effective implementation of the Acts. Greater thrust will be laid on non-institutional care and rehabilitation of beggars. Able-bodied beggars in beggar homes will be put on productive and remunerative work in order to inculcate among them the habit of work and help them in their rehabilitation on release. Education and publicity measures will be carried out to bring about a change in the attitude of the society towards the problem. 15.17.12 The evil of prostitution and its diverse manifestations will need to be tackled not only through strict enforcement of the law but also by building strong public support, with police and community vigilance. Programmes for the rehabilitation of prostitutes and of devdasis need to be more imaginatively designed and implemented. Special programmes will he necessary for the children of prostitutes. The standards of the correctional institutions will be improved. 15.17.13 The growing menace of drug abuse and increasing habit of drinking have ruined many families and endangered the physical security of women. For prevention and control of drug abuse and alcoholism, apart from strict enforcement of the legislation, the role of the media would be enlarged. Counselling, de-addiction and after-care centres will be expanded. Voluntary Action 15.17.14 Voluntary organisations will be encouraged and assisted to work in partnership with State agencies. Increasing emphasis '.vsll belaid on the strengthening of voluntary action for the development of welfare services. The existing grants-in-aid procedures will be reviewed, streamlined and decentralised so as to minimise delays in the sanction and release of funds. The procedures will be simplified without sacrificing the principles of accountability. Administration and Monitoring 15.17.15 Welfare administration will bereori-ented by inducting professionally trained persons at different levels. Capabilities in planning, project formulation and monitoring will he strengthened. The machinery for coordination of programmes will be streamlined. Structural realignments in regard to responsibility for implementation of programmes will not only have a better impact but also result in savings in expenditure. 15.17.16 The functions and the administrative set up of the Central Social Welfare Board need to be restructured in the light of the recommendations made by the review committee set up earlier for the purpose and the administrative structures that have come up in the States over the years, to implement welfare services. The grants-in-aid programme would be decentralised. 15.17.17 A number of social legislations have been modified and amended in the recent past. Their adequacy, effectiveness and problems of implementation would be studied in depth to provide feedback. Mechanisms for monitoring the implementation of legislation will he developed. Research 15.17.18 Research will be strengthened to diagnose social problems and identify the areas which need special attention, thereby assisting in the designing of new programmes and modification of existing ones. Evaluation of programmes under implementation will be systematically carried out. 15.17.19 Studies will be sponsored in the area of drug abuse in order to discern the trends. The incidence of drug abuse among working and school going population also need to he asssessed periodically to gauge the impact of the ongoing programmes. Procedural hurdleS and delay sin the disposal of cases under the Narcotic Drugs and Psychotropic Substances Act, 1985 will be identified. Awareness among different segments of the society regarding the ill-effects of hard drugs will be studied. 15.17.20 Research on the application of science and technology specially in the areas of aids and appliances, will he intensified. The National Institute of Public Cooperation and Child Development and the National Institute of Social Defence will be strengthened, specially in the area of research, training, documentation and development of innovative programmes and alternative approaches/models. 15.17.21 The total outlay for the social welfare sector in the Eighth Plan is Rs. 3857.21 crores, of which Rs. 2375.00 crores is in the Central sector and Rs. 1482.21 crores in States/UT sector. For the nutrition sector, the total outlay is Rs. 1796.31 crores - Rs. 10 crores for the Centra! sector and Rs. 1786.31 crores for States/UT sector. Detaus are given in annex-ures. Annexure 15.1 Eighth Plan Outlays - Social
Welfare : Central Sector
Eighth Plan Outlays -
Social Welfare : States/UTs
Annexure 15.3 Eighth Plan Outlays —
Nutrition : Central Sector
* Included under Integrated Nutrition Education Scheme Annexure - 15.4 Eighth Plan Outlays --
Nutrition : States/UTs
Included under Goa. |
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