CHAPTER -VII

POVERTY ASSESSMENT TO DETERMINE THE FACTORS OF

HEALTH IN RURAL AREAS

CHAPTER-VII

POVERTY ASSESSMENT TO DETERMINE THE FACTORS OF HEALTH IN RURAL AREAS

(Trends, Policies and Health Services).

I-Trends in Poverty

It had been made clear in the previous chapter that the common poor

of the rural areas remained indifferent to the developments and health policies

even after the whole hearted support of the elite Indians. As their root

problem was poverty, their only want was food to satisfy hunger, work to

satisfy needs and shelter to live in.

There were millions of people who did not comprise enough food to

eat, did not have drinking water within their reach, did not have land of their

own to cultivate or enough work to do. The problem was never taken

seriously by the then government. Even today we have approx 32% people

who are living below poverty line as suggested by the Planning Commission

of India 2009-2010.1

It becomes urgent for us to understand the term poverty so as to

determine the health factors, particularly in rural areas. As discussed in the

previous chapters Poverty and health are intertwined with each other’, we

can assess the term poverty in socio – economic perspective:

1 Excerpted from, The Hindu, (Daily News paper) 21.04.2011.

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‘Poverty occurs when sources, to satisfy the wants and

needs of the people, are not available to them in sufficient

and appropriate mode’.

If the resources are not available to the people, they may fall into

moral depression which according to Indian Famine Commission 1901 is:

‘A greatest evil which may lead to physical deterioration’2

It is this dimension that enables us to define poverty in terms of

caloric measures and per capita income, and thus we may identify a poor

person as he, who does not have enough resource to provide himself and his

family with the primary requirements. Planning Commission has also

estimated poverty, based on the formula suggested by the Tendulkar

Committee for computing the number of poor. It had suggested that the

poverty should be estimated on the basis of the consumption based on the

cost of living index3 instead of caloric intake only. It should also include

services such as health and education.4

However, while defining poverty all basic and fundamental human

needs such as, proper nutrition, drinking water, shelter, hygiene clothing,

education etc., need to be accounted for. Nutritional deficiency is also a

leading cause for disease.

2 Report of the Indian Famine Commission 1901, op.cit., p.11. 3 Living Index however includes daily expenditure on food, housing, clothing etc. 4 Excerpted from, The Hindu (Daily News Paper) 24.04.2011.

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According to UNICEF 2005:

‘Malnutrition limits development and capacity to learn. It

also costs life about 50% of all childhood deaths – Lack of

vitamin leads to scurvy and disorder and muscle

weaknesses’.5

Thus we need a proper analysis of poverty, as it is not simply a matter of

physical or material deprivation, but a much more complex social phenomenon.

In Colonial India (19th Century) most poverty stricken areas were out of the

reach of government. The government never tried to find out the health

problems of the peasants. Their basic health problems were, mal-nourishment

and under nourishment. Many progressive measures were done, new

technologies were introduced and researches were done, but the fact remains

that there was economic exploitation which compelled the people to live in

most deadly situation. The situation was well understood by the economists of

that time.

Dadabhai Naoroji said:-

‘…I do not for a movement mean to ignore the very bright

side of British rule, and the many blessings of law and

order which it has conferred on India … My object now is

to show that under the present system of administration

5 Information on the Impact of Nutrition Deficiency, from- MSN, Encarta

Encyclopedia (2005).

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India is suffering seriously in several ways … and is

sinking in poverty’.6

The Acts and Committees were no doubt set up to check out the

problems but the things were not implemented properly. Indian Famine

Commission 1901, after its experience of the previous situations recommended

for the extension of the duties of a hospital assistant on a relief work in this

manner.

- Daily inspection of the sanitary arrangements and water supply.

- Periodical inspection of the food offered for sale and prohibition of the

sale of injurious grain.

- Periodical inspection of all persons on works with special attention to

new comers, weekly gangs and nursing mothers.

- Distribution of quinine on the works to prevent malarial fever and the

supply of anti scorbuties on the appearance of scurvy.7

The Indian Famine Commission of 1880-1885 recommended classifying

the Indian villages into different categories so as to perform the inspections

properly.8

6 Naoroji Dadabhai, Poverty and Un British Rule in India .op.cit. p.1. 7 Report of the Indian Famine Commission-1901, op.cit. p.59. 8 Indian Famine Commission 1880-85 also insisted that the country should be

divided into circles of convenient size, each of which placed under its proper officers with a regular gradation of authority, and with a clear definition of duties’, Report of the Indian Famine Commission 1880-85, part-1, Famine Relief, op.cit.p.48.

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Dr. Cunningham, the Sanitary Commissioner with the Government of

India writes in 1878, ‘Prevalence of disease means either, Generally unhealthy

year from causes which are extremely obscure, in sanitary conditions of the

locality, or Unfavorable conditions of the people themselves’.9

However, these steps taken by the Government were not sufficient. It is

therefore rural areas remained isolated areas and the rural poor could hardly

avail the facilities provided by the Government. It was only after the

independence when Planning Commission of India took the initiative of

improving the general living conditions of the people specially the rural people.

The Bhore Committee in its report of 1945 considered the needs of rural India

and planned for introducing progressive health measures in rural areas. It

recommended:

‘We have taken the countryside as the focal point of our

main recommendations; for it is the tiller of the soil on

whom the economic structure of the country eventually

rests …… we need no further justification for making him

the chief beneficiary under our proposals. The essential

aim of our proposals is to ensure the health of the masses

through the effective working of the centres, we are

recommending for rural areas’.10

Such unfavorable conditions were created by economic factors along

with environmental factors. The statistical records showing the decline of

9 Report of the Indian Famine Commission – 1888, op.cit., p.185. 10 Report of the Health Survey and Development Committee 1945, Vol.-II,

(Recommendations), Government of India Press- 1946- p.5.

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Indian industries and towns suggest that poverty had not been an unfortunate

accident it had been linked with the development process that is continued even

today. Still the Medical and Communication Services had not been provided to

the rural sector. The records also suggest that Gross National expenditure on

the basic needs as health, education and medical measures is still very little.11

After Independence, the Planning Commission of India in its Ist Five Year

Plan covered Rs.1,793 crore, on development initiated on Public Sector out of

which 1,493 crore were involved in expenditure. From 1,493 crore rupees only

254.22 crore rupees were spent on social services .The following table

summarises the total expenditure on social services.

Table-7.1: Total expenditure on Social Services (Planning Commission of India -1955)

a) Education - 123.04 crores b) Health - 83.59 crores c) Housing - 22.80 crores d) Labor welfare - 6.74 crores e) Amelioration of back ward classes - 18.01 crore

Total - 254.22 crores12

11 It is concerned by IInd Five Year Plan (1955-1960) ‘The current levels of living in

India are very low. Production is insufficient and a large lee-way has to be made before the services and amenities required for healthy living can be brought within the reach of any significant proportion of population’. P.21. Second Five Year Plan –Draft outline – GOI Planning Commission on p.21.

12 Ist Five Year Plan – A draft outline – GOI Planning Commission (1950-55), p.57.

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The above table suggests that even in the Independent India Health is

not being taken as a major problem. Though the constitution of India in

Articles 36-51 has enunciated in (the Directive Principles of state policy)

‘To regard the raising of the level of nutrition and the

standard of living of the people, as among its primary

duties’.

(II)

M.K.Gandhi and his Constructive Programme:

After his first Satyagraha in India in 1917 to end the cruelties of Indigo

planters on Champaran Kisans, he opened the model national schools there to

educate the poor people, having the vision that the programme would further

be launched across the country. Gandhi asked his assistants to spread the

gospel of health and sanitation among the poor.

We see initiative of poverty reduction and health improvement in M.K.

Gandhi’s Constructive program .Gandhi pleaded for building a village republic

that is a self sufficient and autonomous village. He said:

‘The village should be a self sufficient as far as its basic

needs food, clothing and other necessities are concerned.

Its economy should be planned with a view to provide full

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employment to all the adults of the village so that no one

is forced to migrate to the towns’13

After independence the Planning Commission on India also had the

same initiative and in its (Ist five year plan) suggested in its approach to

planning:

‘In the reduction of unemployment and under

employment, cottage and small scale industries have an

important part to play’.14

Gandhi felt strongly the need for including nutrition, sanitation, and

health care in the agenda of the Congress which incorporated village nutrition,

and sanitation work as a means of improving health status.

Gandhiji said:

‘The present programme is the foundation of all round

improvement in the tottering conditions of the Seven

Lacks of Indian villages. It is the work that is long

overdue, no matter what Indian political condition is’.15

13 Shan Ghanshyam, ‘De- Centralised planning in a Centralized Economy: A study

of Sarrodya Programms’, in Petter Robb (Edited) ,Rural South Asia : Linkages change and development’ Pub. 1986. p.205.

14 Ist Five year plan 1950-55, op.cit. p.57. 15 Collected works of Gandhi, No.60, p.415.

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He insists that health is a key to happiness he says:

‘To a true servant of humanity the question never arises as

to the best form of service when we have realized the

majesty of the moral law, we shall see how little our

happiness or unhappiness depends on health, and success,

and fame, and the like’.16

Along with health issues, village sanitation and education in health and

hygiene were also an integral part of his plan of rural reconstruction Gandhi

lamented that a sense of national and social sanitation was non-existent among

the villagers of India. He apprehended if the rules of personal domestic and

public sanitation are strictly observed and due care is taken in the matters of

health and hygiene, illness or disease would not have any occasion. Hence

Kasturba Gandhi, Ankitabai Gokhle, Anandi Bai, Manibehn Parekh and Durga

Desai organized classes in village Champaran to give the villagers lessons in

cleanliness, hygiene and sanitation besides primary education.17

Gandhi held government responsible for famines uncured in India.18

According to him heavy export of food grains and forest cutting resulted to

famines. He also urged for the promotion of small scale industries for self

employment .He opposed Industrialisation because it was creating slums.

16 Quoted from ; M.K.Gandhi, ‘Voluntary Poverty’ Compiled Ravindra Kelekar.

Pub. Navjeevan Press Ahmadabad-1961. P.30. 17 M.K.Gandhi, An Autobiography: The Story of My Experiments with Truth,

Ahmadabad, Navjeevan Publishing house, Pub. 1976p.350. 18 ‘HARIJAN’, 31st March, 1946, also HARIJAN,19th May, 1946.

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Along with his constructive program All India Village, Industries,

Association, was also involved and Gandhi introduced the workers of AIVA

about implementing the use of unpolished rice and also regarding rural

hygiene.19

Regarding sanitation he said ‘Poverty is no bar to sanitation’. He told a

group of Shanti Nikatan students –

‘The conditions of the inhabitants of the villages would

continue to be symbolized by the garbage dumps one finds

in the villages, ‘so long as enough attention is not paid to

sanitation’.20

(III)

Poverty Reduction Strategies in Urban and Rural Areas:

After independence, in response to the poverty incidences in India many

poverty reduction strategies are adopted by the Government. India’s Poverty

Alleviation Programmes (PAPs) are run by the Government of India, the State

Governments, and the district and local authorities. Since India’s independence,

the approach to poverty alleviation has taken shape through the five-year plans.

19 ‘Hindustan Times’,(News paper) Sept., 1946. 20 C.W. 87, pp.229-30 (7 April, 1947). Amit Mishra has elaborated the Gandhian

Constructive program nicely. Please see Amit Mishra ‘Public Health Issues and Freedom Movement: Gandhi on Nutrition, Sanitation Infections, Diseases and Health Care’ in Kumar Deepak, Disease and medicine in India, op.cit., pp.249-262.

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The Fifth Five-Year Plan (1974-79) finally addressed poverty removal as a

principal objective.

The Sixth Plan recognized the limits of the ‘income growth’ approach to

poverty alleviation. The Ninth Plan identified the importance of basic services

in poverty alleviation and placed major emphasis on basic services as (safe

drinking water, primary health facilities, universal primary education, nutrition

to school children, and shelter for the poor, road connectivity for all villages

and habitations, and the Public Distribution System).

While urban growth can be seen as positive for economy, it has many

serious problems. With the growth of cities the slum areas also grow rapidly.

Rural migrants come to the cities in search of work and settle here which

aggravates the housing problem and water supply also become adequate.

Government’s urban poverty reduction strategies have three dimensions –

Livelihood, (housing) employment, health and education.

1. Livelihood/housing:

India’s first initiative to eradicate urban poverty was the Subsidized

Industrial Housing Scheme (SIHS) in 1952. Another important development in

1954 was the establishment of National Building Organisation (NBO), the

United Nation’s regional housing centre for Economic and Social Commission

for Asia and the Pacific (ESCAP). The Slum Areas Improvement and

Clearance (SAIC) Programme was launched in 1856 for Class III and IV

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government employees, including scavengers, gardeners and sweepers, The

Valmiki Ambedkar Malin Basti Awas Yojana (VAMBAY), 2001 tried to

identify and meet the shelter needs of the urban poor.

2. Employment:

Swarna Jayanti Shahari Rozgar Yojana (SJSRY) was launched during

the Ninth Plan. The key objective was to provide employment opportunities to

the urban poor and the jobless by encouraging them to set up self-employment

ventures or by providing different possibilities of wage employment. Many

other schemes are being run with the help of Government. The Swarna Jayanti

Shahari Rozgar Yojana was launched in 1997. The SJSRY Urban Self

Employment Programme (USEP) targeted the urban poor BPL in all towns,

unemployed and underemployed youth, 30% of which are women, and 3%

disabled. The following self-employment programmes are being run in India in

present period:-

SGSY: Swarna Jayanti Gram Swarozgar Yojna was launched with effect

from Ist. April, 1999.

JGSY: Jawahar Gram Swarozgar Yojna was introduced in April 1999.

EAS: Employment Assurance Scheme was started on 2nd October, 1993.

Food For Work Programme: was launched in February 2001.

SGRY: Swarna Jayanti Gram Rozgar Yojna was launched in September, 2001.

Annapurna: Scheme came into effect from 1st. April, 2000

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3. Health and Education:

Cities without Slums (CWS) Programmes were developed in July 1999.

The main purpose of the CWS initiatives is to eradicate slums by upgrading

them, it also attempts to bring about better social, economic, environmental and

governance conditions within poor urban communities. Thus the CWS

initiative seeks to:

• Constructing or rehabilitating community facilities including health

centres, children’s nurseries and public open space.

• Improving access to health care, education, and social support

programmes to address issues such as security, violence, and

alcoholism and drug abuse.

At least more than 80% population is residing in rural areas. So the

percentage of poor in rural areas is far greater. Agricultural wage earners, small

and marginal farmers and casual workers engaged in non-agricultural activities,

constitute the bulk of the rural poor. Poor educational base and lack of other

vocational skills also increase poverty. The creation of employment

opportunities for the unskilled workforce has been a major challenge for

development planners and administrators. So poverty reduction strategies of the

Indian Government, in rural areas, have some dimensions i.e. providing self

employment, food (health) and land reforms.

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Providing Self Employment:

The Integrated Rural Development Programme (IRDP) was started from

1978-79 which included training of rural youth for self employment, supply of

improved tool kits to rural artisans.

Swarnajayanti Gram Rozgar Yogna (SGRY) was started in 1999 which

aimed at organizing rural poor into self held groups. In the same years Jawahar

Gram Samridhi Yojna (JGSY) was started for the creation of rural economic

infrastructure.

We also notice the attention of Indian National Congress towards

Technical Education and Industrial Progress at its IIIrd Annual session in 1887

the Congress resolved:

‘That having regard to the poverty of the people it is

desirable that the government be moved to elaborate a

system of technical education to encourage indigenous

manufactures by a more strict observance of the orders

already existing in regard to utilizing such manufactures

for the state purposes and to employ more extensively than

at present, and talents of the people of the country’.21

Jawahar Rozgar Yojna and Jawahar Gram Samridhi Yojna utilized their

funds in creating schools buildings health infrastructure etc.

21 Resolution at the third Annual Session of INC held at Madras, 1887 (28, 29, 30th

Dec.), p.65.

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Rural Health Programme:-

The provision of adequate medical and health services for the rural

people is not easy, but at the same time, it is very urgent. Medical care is no

doubt fundamental for health, but an adequate family income, proper food,

housing and clothing are also essential for health. Since rural prosperity

depends on agriculture, a well ordered farming economy is of prime necessity

to the assurance of adequate income for most of the rural population. In rural

areas specially health is adversely affected by unsatisfactory, insanitary and

overcrowded dwellings, and since the occupation of people living in such

dwellings goes with poverty, their effects are often aggravated by defective

diet, malnutrition and so on.

The frequency of illness in such areas in greater than those of adverse

characteristics, thus we notice marked increase in the incidence of pneumonia

and Tuberculosis and other respiratory disease. So it is essential that we should

analyse the factors affecting rural health i.e. housing, sanitation and water

supply, nutrition, sickness etc.

Housing:

As Buchanan’s survey of early 19th Century - shows that village houses

were ill ventilated; furthermore Leaky roofs, absence of flouring, ill repaired

houses, smoke and damp, form a favorable environment for respiratory illness.

The purpose of village planning is primarily to utilize the land to the best

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advantage of the community by making suitable provision for all its needs. The

Community Project authorities have outlined the following features for village

planning, on the assumption that the average village has a population of 500

distributed in about 100 families.

(i) Two surface wells, tube wells or tanks for drinking water.

(ii) Adequate facilities for drainage.

(iii) One third of the area of the village should be kept reserved for housing.

(iv) Road system so developed as to link with the main road.

(v) School for primary education.

Water Supply and Sanitation: The surveys have also disclosed the fact

that the areas where water supply and waste disposal have been properly

attended to, cholera, typhoid, and dysentery have almost disappeared but most

villages did not have pure water so malaria was found responsible for nearly

65% of illness in rural areas.

It is therefore essential that following steps may be taken to eradicate

poverty and to implement health policies and proper sanitary measures in the

rural sectors.

The Government of India, Ministry of Health have prepared s scheme

for safe water supply and sanitation in the rural areas which will include.

(i) Construction of protected wells and other types of water supply, and making sanitary improvements in the existing wells,

(ii) Provision of Public Health Engineering consultant services.

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(iii) Procurement and distribution of major equipment and certain other materials for the village water supply.

(iv) Helping the States with the necessary educational material.

Measures for controlling communicable diseases:

Health services for certain important communicable disease,

should be provided primarily in rural sectors. As recommended by Bhore

Committee, protective vaccinations and other preventive measures as

segregation and disinfection should be adopted.22

The Nutrition Advisory Committee established by IRFA recommends:

‘The first step in planning nutritional problems is to

estimate the average consumption of the various foods by

the population, preferably on a per capita basis. The rough

data about food intake so obtained should be checked by

family diet surveys. The state of nutrition of the population

should be investigated by the Medical and Public Health

workers’.23

Public awareness is essential because most of people are quite unaware

of the facilities provided by the government and they go to the private

hospitals. However, lack of staff and medical aids in government hospitals is

also evident.

22 Report of the health Survey and Development Committee 1945 Vol.-II,

Recommendations, op.cit., , pp.137-142. 23 Ibid., p.71.

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‘Only 20% of Indians are covered by Public health sector of government, and the rest take resource of Private sector, which is quite expensive’.24

Public should be well aware of the nutritious value of food items and

average intake of calories for their bodies. M.M.Martin during his survey found

that the people of Bihar and Patna did not take nutritious food. Out of 52000

families in Bihar only1-64 families used to take oil in their foods and only 16-

64 families used to take milk. It suggests that most of the people were taking

under nutritious food, so they were easily subjected to diseases.

Even today people are not quite aware towards their diet. Report on

Nutritional Intake in India provides us information about daily per capita intake

of calorie, protein & Fat, by the people living in urban areas and those living in

rural areas.25 The people living in the rural areas are very much indifferent

towards in their health. Ignorance and illiteracy has been the strongest reason

for this indifferent because they are unaware of the caloric values of the food.

Even after the independence the government has not taken the initiative of

opening the governmental hospitals in remote areas. People have to rush

towards the cities for treatment but poor people hardly go due to lack of

money.

24 Guru Swami, M and Abraham, R.J., ‘Redefine poverty: A new poverty line for

New India’, in Economic & Political weekly, June 24, 2006 p.2537-38, Vol. XLI, No.25.

25 Government of India (2001): NSS Report No.471: Nutritional Intake in India, 1999-2000 National Sample Survey Organization, has prepared the following table for per person caloric intake.

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Table-7.2: Percentage of expenditure by Indian household and per caipita intake of caloric, protein and fat per day by the average

Indian.26

Sectors % exp. on food

% exp. on cereals

Per capita Per day calorie (Keal)

Per capita Per day protein (0.0gram))

Per capita Per day fat (0.0 gram)

1 2 3 4 5 6

Rural 55.0 18.0 2047 57.0 35.5

Urban 42.5 10.1 2020 57.0 47.5

Proper vaccination programme should be run in rural areas. There

should be provision of at least one hospital within 2 kilometers radius

everywhere.

The Bhore Committee has also suggested the following measures

improve the general living conditions of people.

1. Physical Health Education

2. Health Service for Mothers and Children

3. Health Service for School Children

4. Occupational and Industrial Health Services

26 Report on Nutritional Intake in India 2004-2005, NSS, 61st Round, July 2004-June

2005, Report No.513 (61/1.0/6), National Sample Survey Organization, Ministry of Statistics and Programme Implementation, Government of India, May, 2007.

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Poverty and Malnutrition:

Malnutrition is particularly high among poor house-holds where the

mothers have poor nutritional levels, less education, and poor access to

antenatal care The following table gives the quantities of the various food stuffs

for a well balanced diet, the usual diet of the villager, and the percentage of

people consuming below the standard level as found in a recent survey by the

Nutrition Section of the Indian Council of Medical Research.27

Table-7.3: Table showing well balanced diet, diet of the villager and the Percentage of people, consuming below the standard level.

Item of food Well balanced per day

Villagers usual diet per day

Percentage of people consuming below desired level

Cereals 14 20 41.6

Pulse 3 1 73.3

Leafy vegetables 4 2 75.8

Non-leafy vegetables 6 2 75.1

Fat 2 0.5 76.5

Milk 10 2 67.2

Meat 4 - 59.7

Sugar & jiggery 2 - 64.4

. 27 Cited in Praphulla C. Dutta, ‘Rural Health and Medical Care in India’, Published

by – Army Educational Stores Ambala, 1955.

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As has been observed, the lowest incidence of child malnutrition is not in the

richest but in the middle income states with progressive social policy. So it

should be emphasized that social and food security policies, which improve

incomes of the poor as well as access of women to education and health care,

would reduce both poverty and malnutrition.

IV

Initiative of Improving Health Status of Females:

The status of female education in British India was very regretting. The

Census reports show the number of educated female was very less almost

negligible in comparison of males. It has been the greatest factor responsible

for social evils and health problems among the females. In poor families while

all the members suffer, it is women, particularly widows and girls members

who suffer the most. Chronic energy deficiency is generally higher among

females in most of the States of India. Mothers have poor nutritional level and

so children do not attain their full growth potential and productivity level

becomes slow.

As regards infant mortality there is no question that the death rate in the

first month is in a large measure due to improper management at the hands of

‘dais’ with an increase of trained nurses we could reasonably count on a lower

mortality. It is only by education that we can hope to cope with this evil and it

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should be the duty of educational department to see that every potential mother

knows how to rear a child.

The three main agencies of education, in British India were the

Government Christian Missionaries and Social reformers, all of whose efforts

were directed largely in the same direction their early efforts in the 20th

Century were made mainly within the traditional frame work of Indian society.

However in the later years several measures were introduced which made

education more modern and functionally relevant for women.28

In the contemporary world it has been realized that women have a

significant role in the development society. So issues relating to female

education motherhood and Child survival needs to be understood as an integral

component of total development.

The importance of nutrition education of mothers was realized and

nutrition of the pre-school child combined with nutrition education of mother

was therefore been given priority on the nutrition programmes during the 4th

five year plan. Pandit Nehru also laid stress to it by saying:

‘The building up of a nation depends on building men and

women and the process of building men and women

depends very considerably on what is done to children. It is

therefore of high importance that we pay attention on the

28 Azra Asghar Ali, Emergence of Feminism Along Indian Muslim Women-1920-

1947.op.cit p.52.

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well being and growth of children the basic habits formed in

the early years and the way their minds have been

conditioned then, will play an important part when they

grow up …, therefore a great deal of attention should be

paid to them.’29

Promotion of Indigenous system of Medicine:-

Indigenous medicine, religious practices and social customs are

inseparably intermingled in our daily life, especially in the villages. Of course

research in Ayurvedic, Unani and other drugs must be encouraged.

While the broad policy objectives articulated in the planning documents

have been quite appropriate, the corresponding development programmes have

not been very effective in achieving the objectives. In brief review of the

policies and programmes for the development of urban and rural areas both

presented in this chapter shows that the policy objectives need to be clearly

defined. The strategies to achieve the objectives should be more approachable.

However, the success of this effort will largely depend on what action

programmes are developed and how they are implemented.

29 Quoted from National Health Seminar ‘On the role of the Voluntary agencies in

the implementation of Public Health Medical Care and Family Planning Programmers, Deco., 29-31, 1965, by Dr. R. Karnad- Nutrition in the Fourth Five Year Plan, p.47.