While India has, over the last fewdecades, made considerable progress in ensuring childsurvival and basic education, much remains to be done. Whenthe major indicators for the Indian child's development-- maternal mortality, birth weight, immunization, nutritionlevel and basic education - are compared with those of otherdeveloping countries, it is clear that the Indian childurgently needs better interventions. In the context of sucha situation, the vision for the future has to be an Indiawhere all children have all the chances they need foroptimal development. The emerging question is, despitesignificant investments and a conducive policy framework,why is the status of the Indian child still far fromsatisfactory? And, what then is the way forward to realizethis vision? It was in this context that a multi-sectoralworkshop entitled "Reaching Out to the Child" wasorganized collaboratively by the Education and Health,Nutrition and Population teams of the World Bank on February21 and 22, 2000 with the participation of Indianprofessionals from health, nutrition and education sectors;and senior representatives of the Departments of Health,Education, and Women and Child Development (WCD). Theobjective of the workshop was to initiate multi-sectoraldiscussions across the government and non-government sectorswith the aim of establishing a constituency for thedevelopment of an integrated, comprehensive and convergentapproach to child development. This report synthesizes theobservations and conclusions from the five studies and thedeliberations of the seminar, supplemented by review ofother relevant documentation. The starting point of thisreport's conceptual framework is the premise that thechild's development must be viewed along the prenatalto11+ age continuum as a continuous and cumulative process.Investment and intervention have to take into account everysub-stage of the child's development process, fromconception through the years of growth to enable the childat 11+ years to reach the basic milestone of successfulcompletion of primary school. Moreover, intervention mustaccount for the dynamic, interactive relationship among thesub-stages of development; among sectors such as health,nutrition and education; and among aspects such as maternalhealth, psychosocial development, and family and communityenvironments. The continuous and cumulative nature of impacthas also meant that the impact of not attaining appropriatedevelopmental milestones, or health and nutritionaloutcomes, or learning capacities, will accompany the childto the next stage. In some cases, "cumulative"failure is the result of an inter-generational transfer ofhandicaps, and the accompanying downward spiral of poverty,ill health, malnutrition, and poor learning outcomes forchildren. For the purposes of the quantitative andqualitative data studies conducted for this report, theframework underlined the critical and reciprocal linkbetween health and education, specifically in relation tochildren, whereby poor health and nutrition work as barriersto attendance and educational attainment/achievement. Thefamily, the community, the state, service deliverymechanisms, and the presence of non-governmentalorganizations, all play important mediating roles andfurther fragment the experience at the grassroots.
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