emerging challenges of nutrition.doc
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Child care in India: Emerging issues and challenges for the 21st century
The Indian Context
Today Human Development is considered to be a very important aspect of a
countrys progress. A nations efforts towards enhancing women and childrens health,
nutrition and education and also its commitment to resolve social issues like child labour,
illiteracy and poverty is relevant in measuring its development. Indias concern for
children is evident in the constitutional provisions, policies, programmes and legislation.
But, for a nation with 160 million children of less than 6 years of age, the task of reaching
out to them is indeed mammoth. The New Economic Policy (NEP) under the Structural
Adjustment Programme (SAP) has created further hurdles by way of scaling down of child
development projects, changing patterns of financial resources and changing composition
of child development programmes ( Saleth 1992). Further, the NEP has also broughtabout changes in the labour market in terms of increase of contract labour and
feminisation of labour. With nearly a 100 million women in labour force, spread across
various sectors of occupations and in diverse regions, it calls for innovation, flexibility and
variations in the programmes for women and children. Thus child care programmes have
to serve the intersecting needs of women and children. For the child it supplements the
care provided by family through its health nutrition, stimulation and pre-school activities.
Very significantly it would play a role in releasing young girls from child care tasks. For
the working mother it provides the
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Reader, Unit for Child and Youth Research, Tata Institute of Social Sciences
In Proceedings of the 7th Early Childhood Convention, Volume 2, pp.99-108.
Nelson, New Zealand.
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support to carry on her tasks of a homemaker, mother and earner. It is important to note
that a large number of women though not gainfully employed, have to be away from home
and child to collect water, fuel and fodder in order to survive and therefore it is essential to
consider these women also for child care services. Further, it has been seen that in absence
of child care services womens participation in literacy programme, income generation
programmes and health care activities are reduced thereby decreasing their own chance for
development and also their participation in the development process.
Considering the above Indian context this paper details out the child care
programmes in India in terms of its outreach, features, relevance for child development and
also the quality of child care services.
Care by Kith & Kiln
In India, even today the social support through Kith friends/neighbourhood) and
Kin (family) is strong and is often the main source of child care. In a recent study (Datta
& Maheshwari 1996) in Mumbai, 43% of the dual earners depended on their family that is
the grandparents for child care. Particularly so, if the grandmother lives in the same
house, because the child does not have to change the environment and since natural ties
exists, the mother faces no conflicts in leaving child with the grandmother. Many parents
are only weekend parents as their child stays all week with grandparents. In the
disadvantaged groups nearly 66% of the mothers took care of the child herself (GOI,
1985). This is specially so with women who are agricultural labourers, contract labourers,
piece-meal workers and self-employed women. Sometimes children are left tied in
hammocks under the trees or left unattended in dangerous environments like construction
sites. Women working on piece-rate like Bidi-makers tend to lock the child in a room so
that child does not come in the way as more she works the more she earns. Care by a
sibling is a very common form of child care but a cause of concern as it denies the older
child educational opportunities and childhood itself. Looking at child care in Agricultural
sector it was seen that sibling involvement was about 13% in Mizoram and Gujarat and
nearly 82% in Kerala. These children were as young as 6 to 14 years. Such young
children who are kids themselves have no skills for child care (Sriram & Ganapathy 1997).
A significant study by Shah et al (1979) has shown that 47% of study children in rural
Maharashtra were looked after by sibling and that incidence of severe malnutrition was
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55% when siblings were 6-8 years of age were in charge compared to 21% grandmother
care and 8.5% under mother care.. If no family member is available very often children
are left alone for periods of time. In many slums children wander around unsupervised as
most adults and older siblings have to work for family to survive. Among the urban middle
class latch-key children are common feature as child care facilities like before and after
school are not existing. School going children do not like to attend day care programmes
for young children as there is no activities of their interest in these centres. At such times,
parents are forced to allow children to be on their own in the home with neighbours
keeping an eye on them. However such situations have potential dangers and may also
have adverse effects on children.
Within the home setting, child care is also done by employing Maid or Ayah
who will look after the child and also do domestic chores. The person could be of any age
range from a teenager to an old adult. This is a popular form of child care in urban
middle class families as they find this labour is cheap and in plenty. The dependence on
such a service is also because child care choices are not available for families who are
willing to pay. However the children under this form of care scored very low on
intelligence and social maturity tests compared to children in other forms of care (Datta
1994).
Women-Centred Programmes & Child Care
By the year 2000 there will be 800 million women workers in the labour force.
More than half of this increase will take place in Asia. In India too there has been a steady
increase in women in labour force. Today there are nearly a 100 million workers as
against 85 million in 1991. The Indian women are largely employed in the primary sector
of the economy and they constitute 81.5% of the female workers. The regular salaried
women workers represent 1.4% and 0.9% of the total workers (15-59 years) in the rural
and urban areas.
Among the poor and resourceless there is tremendous pressure to find employment
for survival. But their low literacy restricts their entry into the labour market. Among
those employed there are 88% females in rural areas who are illiterate while the urban
figure is 56%. The 93% women are in unorganised sector working in fields, construction
sites, contract and casual labourer, and also petty traders. The opportunities for
employment for the educated have been provided by the organised sector. The public
sector has provided opportunities for women especially in banking. Married women prefer
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jobs that are considered respectable and therefore are found in teaching, health related
work and office clerical work.
A large number of working women (nearly 75%) are in the child bearing age
(Swaminathan 1998). As many as 24 million working women have children in age group
0-6 and need some child care support. The Committee for the Status of Women in India
(CSWI 1974) noted the absence of adequate child care service as an obstacle in womens
economic and political participation. Besides, the National Perspective Plan (1985) and
Shramshakti (NCSW 1988) have again reiterated the plight of women who have to
struggle for survival and have no child care support.
The response of womens programme to child care has been in two directions.
One response was in relation to womens development programmes while the other
response was in terms of women workers and their rights. The first few decades after
independence the womens programmes were formulated with a welfare perspective, by
providing support for health and nutrition and trying to enhance her skills in child care.
Later with the perspective of womens participation in development, education, training
and income generating activities were also included but with no consideration for facilities
for child care support. The only programme for working women was the grant-in-aid
scheme called creches for children of working and ailing women (1975).
The scheme lays down the norms for grants and also outlines the basic
requirements of a creche programme in term of materials, equipment and staffing. Today
there are 12,470 creches with 3.11 lakhs beneficiaries. A recent study points out that
majority of the creche units were located in backward, far-flung villages and also in those
areas where women were working either in the fields or in unorganized section. However
meagre budgeting allowances and untimely release of grants interfered in providing
appropriate facilities for children like nutrition or play materials (Gopal & Khan, 1998).
The evaluation of the scheme points out to the lack of stimulation, inadequate physical
space and facilities and tendency to make the programme into a half-day pre-school
programme due to lack of funds and easier management of programme with minimum staff
(Rane et al, 1986, Paranjpe et al 1981, Datta 1989). The budget sanctions have not been
increased since 1990 resulting in no expansion of programme and giving no scope to
enhance the quality of the programme. For example, in Maharashtra, the creche scheme
had about 996 units in 1996 which came down to 912 in 1999. Besides this, it is also seen
that since 1994 when the nutrition allowance was increased by mere 15 p. per child per
day for the past twenty years there is no increase in any items of funding, even salaries. It
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is expected that the NGO supplements the budget. The unrealistic budgets forces the
creches to work in poor quality conditions.
In the nineties when womens empowerment was the focus in programmes, the
Mahila Samakhya (MS) was launched. MS means education for womens equality and is
an innovative programme that is need based, process-oriented and participatory by nature.
It acknowledges that substitute care of children is intrinsically linked to womens
development and empowerment. The Mahila Samakhya programme in Vadodra (Gujarat)
has been able to facilitate the rural woman in their attempts to create child care facilities
for their children. The essential steps have been to create awareness about womens
multiple roles and situations in society, make a collective decision about type of child care
support, choice of place, timings, and the programme (Sriram 1998). Such a programme
not only provides direct benefits to working mothers and their children through the child
care programme but addresses many other issues also. The programme approach
encourages mobilisation of villagers particularly women and gives authority to community
to design and manage their child care centre. However lack of funding in Mahila
Samakhya programme for child care makes it difficult to run the centres and sustain them.
Provision ofstatutory creches in factories and plantation has been one of the first
attempts to address the women workers needs. The Factories Act of 1947 expects
employees who have 30 or more women employees, to provide for child care services in
factory premises. The act specifies the details of staffing, materials and equipment for the
centre. Ranes (Rane 1978) observations had shown that there was reduction in factory
creches because employers employ less number of women or older women and thus escape
from the law. It is therefore argued that such laws may only serve to limit womens entry
into the formal sector jobs. In work places where creches exist there are few children in
most creches and one main reasons for this is that the workplaces are at considerable
distances from homes creating commuting problems. In cities like Mumbai women prefer
to prolong their maternity leave with other leave and to settle the child in a neighbourhood
child care on whom she would depend even when the child starts his pre-primary at the
young age of 2 years. Though there are roughly 10% women in organised sector, the
Factories Act covered only 3-4% of them as the rest are not eligible under the Factories
Act.
In 1940s when the Act was initiated the main focus was on health and therefore
specification for health care were given rather than any emphasis on developmental
activities for children. Observations show that generally nurses who are employed do not
interact with children and therefore children are left idle, brooding and totally uninvolved
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in any activities. Efforts have to be made to bring in amendment in the Act so that holistic
development of child becomes the focus of programme. At present the Act is applicable
only when there are women workers. But if we believe that child care is parents
responsibility and only the mothers then this Act should be made applicable to all factories
who have more than thirty workers. This would also usher in the involvement of
employees in child care. On the positive side it is worth noting that even today, in some
companies the creche is a great success because the employers have invested in it by way
of more trained staff, greater inputs in nutrition and health care programme and
emphasizes on childs development through play.
The Plantations Act is similar to Factories Act but it caters to the women workers
in plantations in rural areas. Gopals study (1983) points out the inadequacy of
programme outreach. The creches which are functioning are having inadequate, untrained
staff and centres do not have space nor play materials to stimulate children and very often
they were functioning as Balwadis (Pre-school). Lack of guidance and supervision gives
no opportunity for creche workers to improve their programme. However Swaminathans
(1985) comparison of creches in Plantation and Creches under the Coal Mines Act shows
that creches in plantations have an edge over the coal mines as they fulfil the three
objectives, namely, provide a service for working women, provide for development of
young children and enable young girls to attend school. Thus apart from the legislation
which forced employers to offer child care facilities, the initiatives from them, otherwise,
have been very sporadic. Recently, the University Grants Commission has shown an
interest in developing campus child care centres to be used by university employees and
also people in the nearby community. Such initiatives would help develop different child
care services but the challenge is in making them into good quality sustainable
programmes.
Though trade unions have played no role in creating a demand for child care
facilities, the Self Employed Womens Association has shown how a union can
successfully contribute to the employees need for child care. The Self-Employed
Womens Association (SEWA) is confluence of three movements - the labour, the co-
operative and womens movements and its main activities are union, co-operation and
support services (Pandit 1995). SEWA found that the poor women who were working in
tobacco fields and factories had no child care options and were taking children to work
place creating dangers for their health and safety. After searching for all possibilities, it
became increasingly clear that SEWA would have to set up its own creche with support
from women panchayat, local leaders and tobacco factory owners. Shaishav (childhood)
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was the creche programme launched and today there are about 20 creches and shaishav is
a registered co-operative of child care workers. This experiment has shown the
possibilities of self-reliance because the donor dependence has gone down from 80% to
66%. Besides the employer contribution has gradually increased from 1% to 16%. Milk
from milk co-operatives and free medical attention from community doctors has supported
the programme. Thus SEWA has demonstrated that employees, community and parents
can come together to develop self-reliant and sustainable programmes. Secondly, it clearly
shows that child care has to be a part of holistic integrated strategy for the development of
poor as it permits women to work and improves their economic conditions (Pandit 1995 ).
A successful collaboration of employer and an NGO can be seen in the twenty
year old Mobile Creche programme. Considering that construction workers are shifting
population whose home and workplace shift time and again dictated by the construction
industry, the mobile creche moves with this group and provides for their child care needs
(Khalakdina 1995). Mobile creche has successfully demonstrated how the needs of
women and children can be well integrated into a successful programme. The daily
programme offers rich, diverse, multifaceted and satisfying mix of activities, using the
simplest of material and at low cost (Swaminathan 1985). Mobile creche not only caters
to children below 6 years but also has non-formal education for older children. It provides
support to the family (particularly women) by having health education and literacy
programmes. The materials in the activities of mobile creche are a fine example of use of
low cost materials and by using methods like street plays, puppets they have successfully
reached to children and adults. It has demonstrated through the years, that investment in
child care gives good returns. The tremendous experience over the past twenty years have
helped them to develop effective training module and also play a major role in advocacy.
Government and NGO efforts have been to cater to disadvantaged women and
children but the responsibility to provide child care for other groups fell on the private
sector. Day Care Centres in private sector are very few as they are not cost-effective,
Considering the space, staffing and other infrastructure requirements. The initiatives
from individuals and womens organisations have created some day care centres in the
urban areas. These day care centres provide care to about 30 children and major
responsibility for care lies with the maids or ayahs who are untrained with education
upto higher secondary (8th grade). Though space and materials exist in centres, they are
never utilized to stimulate children. It appears that only custodial care is offered in many
of these centres (Datta 1993). Since the need for child care was growing, family based
group care (Family Day Care) by housewives became a growing phenomenon. In a
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Mumbai study on dual earner, among all who used child care services, 65% used FDC
while only 25 used Day Care Centres. The family day care offers a home like
environment and is preferred by parents who want their children to have personal care.
Besides Family Day Care is a convenient and flexible programme. The mother can make
arrangements for care of all her children, arrange for convenient hours of care and allow
flexibility to take care of emergencies. The mother also finds the location of the family
day in her own neighbourhood an added boon. it is possible for parents to make
arrangements with providers according to their work schedule and special needs of
children. The analysis of Family Day Care (FCD) in Mumbai (Datta 1995) showed that
caregivers were middle-aged middle class women with high school education. They
contribute 45% to the family income through their earnings. But they had undertaken no
training which reflected in the poor quality of the programme which provides no mental or
physical stimulation. On an average an FDC had ten children of mixed age groups that is
infants, toddlers, pre-schoolers and at times even school children. Since they offered
flexibility in timings the working hours of the caregiver was spread over 12-14 hours.
Generally caregivers managed on their own single-handed and at times had help from some
family members or ayah/maid. Observations show that routines of feeding, getting ready
for school and sleep occupy most of the time (Datta 1998). The children though not
involved in specific activities occupy themselves through interaction or moving around the
house. Family day care surprisingly continues to be an urban phenomenon in spite of the
fact that it can be a service developed for any segment of the population. Neither
government nor NGO have felt the need to use this model, in spite of them continuously
talking of community and womens participation and low cost models.
Child Care Programme and Child Development
The welfare perspective dominated in all the childrens programmes in the first
three decades after independence. Balwadis, crches and Bal Vikas Centres all had the
major focus of supplementary nutrition and health care. Though Balwadis were meant to
enhance the school enrolment and retention, they turned out to be just feeding centres. The
early childhood programmes were run by different ministries like health, welfare, rural
development. It was then felt that due to lack of intersectoral linkages and poor
convergence of services, the programmes were not meeting targets nor were they creating
the appropriate impact. The fifth five year plan saw the emergence ofIntegrated Child
Development Services (ICDS) scheme.
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The ICDS is a comprehensive scheme which aims at enhancing survival and
development of children from the vulnerable sections of society. Starting with 33 projects
in 1975, today the scheme covers 2.22 crore in about 3926 operational ICDS projects.
Though ICDS does not provide child care services directly, it does have 0-3 year old
children as its target group for health and nutrition programme. But it is commendable
that over the three decades the ICDS has played a major role in reducing Infant Mortality
Rate (IMR), reduction in severely malnourished children and increase in school enrolment.
Now that the structure is in place, efforts have to strengthen it and achieve the targets set.
As Myers (1985) points out, The ICDS shown a high degree of integration at a
conceptual level and in policy planning, the utility of the Anganwadi Centre in facilitating
convergence, the breakdown when one person is expected to serve as the integrating force
for various activities without adequate support from the community, and the fragility of
organisational devices attempting to secure collaboration among different parts of a
bureaucracy.
In the last few years the increase in malnourished children has forced the ICDS to
give special attention to the 0-3 years age group which is the age when malnutrition sets in.
It was felt that anganwadis should become anganwadis-cum-day care centres. In 93-94
the National Creche Fund was set-up through which some anganwadis were given
additional funding for day care programme. The national creche fund also has grant-in-aid
for creches but only for five years after which the NGOs have to be able to run the centre
independently. At present about 2000 creches are run all over India under the National
Creches Fund.
Whether child care programmes are looked at as support services for women or as
supplementary services for children, it must be kept in mind that the children who attend
these programmes are spending most of their waking hours in the group settings and
therefore what happens in these child care programmes will determine their development.
Researches indicate that the distinctive ecological characteristic of the environment have
the power to produce immediate and long term effects on children. The three main factors
which determine the environment of a child care programme are adult-child interaction,
peer interaction and the activities in the programme. The extent to which caregivers and
personnel in their interactions with the children, engage in behaviours that stimulates,
sustains and encourages task oriented activities on the part of the child, will influence the
development of children. Group care also offers opportunities for peer interaction which
helps in social and communication skills. Besides the organized activities and spontaneous
play become aspects of stimulation that help in positive developmental gains for children.
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The first few Indian researches that addressed these issues studied the development of
children under different types of programmes. Clear developmental differences were seen
on measures of cognitive and social development among children under maid care, group
care and grandmother care (Datta 1994). The grand-mother care children had higher
scores than children in all the other groups while the group care children were
significantly better in their performance compared to maid care. As grandmothers were
only doing child care task they were able to devote much time and attention to the child
and the group care setting though lacked in any programme and activities, the interaction
with peers which was of mixed age groups helped in the childs development.
Observations in family day care and Day Care Centres further highlighted that the
characteristics of settings itself created environments which impacted the development of
children. For example the smaller group size and homely atmosphere of family day care
helped children to feel secure, social and involved in activities with peers. In contrast the
larger number of children in day care, and more staff did not allow child to make one to
one relationship with adult or peers. Such observations lead further to the issue that it
need not be that all day care centres are bad or family day care are good. Within these
setting there are good and poor quality settings which ultimately are responsible for the
impact on childrens development. Thus Quality became the concern for research. There
is a baseline ofuniversal needs that children have, which must be addressed in a quality
service for children. These include the need for safety, health supports, good nutrition,
positive interaction with reliable adults, the opportunity to explore and exercise their
bodies and minds and love and affection (Evans 1995). As Woodhead points out that
along with this basic or fundamental needs there are socially constructed needs which are
dictated by the culture. Thus quality programmes must respond to these needs. there are
many ways to respond to these needs which will be determined by culture and context.
The issue of quality has not been addressed much in the Indian context not to seek a
definition of quality nor in terms of specifying quality practice. The strategy has been to
address the issue of supply before addressing the issue of quality. This has resulted in
ineffective programmes which deprive the children of full benefits and also result in waste
of resources. Except for monitoring and evaluation of programme there are no other
practices which will ensure in quality like regulation, staff credentials, or even licensing
(Datta 1998).
Some attempts were made to understand child care environment and identify
factors that may determine the quality of a programme (Datta 1993). Research has
demonstrated that large groups was associated with less stimulation and more restrictions.
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It was found that when group size is large a lot of time is spent in routine activities and
there is no stimulation or interaction through play. Along with this if there were too
many age groups, there was greater neglect. At such times infants get some minimum
attention because physical needs have to be attended to; while pre-schoolers, with their
communication skills and mobility are able to demand attention and fulfil their needs. But
the toddler group is most deprived as they cannot yet communicate nor are they completely
independent. Through adult-child ratio is an important factor it did not have a significant
impact on interactions. Adult-child ratio cannot by itself be the principal mechanism for
guaranteeing benefits to children, although it can be an important indicator of staff burden.
The study also shows that interaction between adult and children occur with greater
frequency and duration in family day care.
Training and education of caregivers contributes positively to quality of
programme but not experience. This finding defies the myth that experience is a good
teacher and shows that because the workers work in isolation, they are not able to know
the appropriate practices or bring about change through exchange of knowledge and
experiences. Secondly the burn out syndrome which caregivers may experience after years
of functioning might be making them ineffective in spite of long years of functioning.
Thus group size, staff training and education, and age mix are important
indicators of quality. Specifically looking at what happens to children in high and low
quality setting, it was seen that children in high quality day care centres were able to
indulge in different forms of play while the high quality family day care provided child
with greater opportunities for adult and peer interaction. But whether it was family day
care or Day Care Centre, if it was of poor quality it lacked both adult and peer interaction.
Such studies have become the starting points for understanding quality in the contexts that
are present and understanding the concept of quality from the various stakeholders that are
involved in child care programmes. National Organisation like Indian Association for Pre-
school Education (IAPE) and Forum for Creche and Child Care Services (FORCES) are
taking steps towards bringing together parents, practitioners, politician, policy planners,
academicians to become a force which will not only fight for access to child care services
but will talk of effective quality programmes, which address the needs of women and
children in all sectors of Indian society.
The Challenges
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We have a formidable task of reaching 160 million children who are 0-6 years and
specifically 24 million children who have working mothers and require child care. But the
happenings in the post-independence period has helped to bring in some optimism. The
perspective in the ninth plan is to view child development not only as a desirable social
investment, but also as the right of every child to achieve full development. India has also
responded to the globalcommitment for cause of children. The efforts at universalization
of ICDS, partnerships of NGOs and governments and use of new technology will help us
reach our goals in spite of the many odds we face. At present if a few of the challenges are
met systematically, then reaching out to these children should become a reality.
Child care programmes to a large extent are not available and accessible. This
calls for better outreach of programmes, flexibility in implementation of programmes,
diversity in programmes to be able to reach to women and children in various
circumstances. Thus multiple responses to child care is a must for programmes to be
available and accessible.
The need to establish inter and intra sectoral linkages is becoming urgent to
reduce the costs in duplication of services, underutilisation of service and for developing
an integrated approach to planning. However, it needs to be cautioned here that under the
guise of duplication of services many child development projects are phased out and these
are some signs of cut in social sector investment. In reality today where programmes are
closed childrens development state in terms of nutrition, health and education are a real
cause of concern.
Considering that personnel is the most important aspect impacting on the quality
of the programme, it is imperative that the child development workers be recognized as an
important work force requiring appropriate work benefits. They handle the most
vulnerable group and hold tremendous responsibility for their well-being and therefore
must be recognized as professionals and not just as honorary workers. Setting up
appropriate, recognised training modules, uniformity in wages and creating mobility will
give a chance to this large women workforce its due recognition.
Child care programmes have to consider the intersecting needs of women and
children. It is not a question of just access to the programme for the child but it must be
viewed as an important programme to help women to increase their income, increase the
girls enrolment in school and also offers as a means of creating opportunity for
employment as child care workers.
In spite of inputs from evaluation and developmental researches not much
modifications are made in schemes and programmes over the years. Very often they are
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not addressing the needs of target groups thereby wasting many resources on ineffective
programmes. Programmes like ICDS are facing dangers ofoverload as new aspects are
added to the scheme without increase in budgets or infrastructure. Efforts to involve all
stakeholders in policy and programme planning will go a long way in evolving effective
programmes.
There have been many successful small scale demonstration projects.
Unfortunately they have not made an influence on policy and programming. Attention has
to be given to scaling of projects so that successes in demonstration projects can be
included into national planning.
National consciousness has to raise about quality in child care programmes. At
present large scale programmes are working at larger outreach with such meagre
resources that the per capita costs are reduced to such an extent that there is more waste
than gains from such programmes. Academicians, field practitioners, government and
parents are the important stakeholders who will have to be involved in defining quality
and strategies for quality child care programmes.
There is a need to have a regulatory frameworkwhich will help to standardise
programmes of non-governmental, governmental and private sector. Though regulation is
not the only answer to quality programme but it will help in quality assurance.
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