The participants we need in Phase 3 trials

Context: India should not stick to decennial census operations alone but needs to go a step forward and should recognize already present parameters to know its cumulative capital and potential.

Issues with the Human Capital Development in India:

• Inadequate Data Capturing: For E.g. India’s crime data recording system is not built to capture subtleties like what proportion of pregnancies in India start o? without the consent of women.

• The veil of marriage covers it up legally and culturally.
• Inadequate quantification of intergenerational impact: of a regretful and anxiety-loaded pregnancy by the clinical tools.

• Dependence on Decennial Census: to identify the trends necessary for the national well-being.

• Long-term nature of the census robs us of the opportunity to have a cumulative human potential outlook, regularly updated and spanning across demographic categories.

• Huge Stillbirths: Not every pregnancy ends up in a live birth — evocatively captured by the six­word allegedly Heming­ way novel: “For sale: baby shoes, never worn”.

• There still remains a distressingly large number of stillbirths, sometimes misrecorded as early neonatal deaths.

• Cultural Hindrances: Despite the trend towards nuclear families, pregnancies in India still are familial events where outcomes are eagerly anticipated and impact child development.

• For, E.g. A young, short and under­schooled woman is more likely to have a bad pregnancy out­ come, or, a smaller than expected baby.

• Unimaginative teaching of Anaemic Children: Grading cognitively ill­equipped or ill­taught children on standardized tests is a waste of effort. 

• Similarly,  letting large numbers of young people graduate through courses which are hopelessly out of sync with the expectations of the job interview board.

Valuable Parameters: used to measure Human Capital Development- 

• Gender Issues:

• Consent of the Woman: women are often not consulted over pregnancies.

• Teaching school-leaving girls and boys the notion of consent and basics of contraception, will ensure that the start of every pregnancy will be a desired and happy one.

• Gender Parity in School completion rates: This will help in reducing underage marriage of girls.

• Provisioning separate, functional toilets and sanitary pads for girls, and teaching boys biology and gender differences (of their own and female) are key enablers

• Births and Birth Weight

• A fair proxy for food security, the status of women and the delivery of primary health.
• Inequality Measurement: Making transparent data provisions envisioned under digital health IDs would put to rest the debate about whether some Indians are born more equal than others.

• Height-weight proportion:

• It would help in identifying lack of adequate nutrition, repeated bouts of vaccine-preventable or easily treatable illnesses etc.
• The career of a person will hit a major hurdle if the height-weight proportions at age five are not normal.
• Allows Multi-dimensional co-relation: between the birth weight at the district level. 

• This would reflect the physical and cognitive nurture of human capital that the country can bank on for its future.  

• Schooling and Learning

• Socio-economic and gender parity: Equal access for schooling helps through delayed marriages and the use of reproductive choices by empowered women - 

• Bringing down maternal mortality,
• Improving  neonatal and under-five mortality rates 

• Supporting environment: 

• Deworming, school toilets, sanitary pads and bicycles for girls are progressive policy steps in the right direction
• Adding remedial training and a?rmative feedback for teachers will be transformative.

Way Forward:

• Ensuring gender parity in completion of education: so that women become empowered enough to avail their reproductive rights and ensure the healthy development of children.
• Taking advantage of demographic dividend: by regularly reviewing the correlation between birth weight and five-year height weight statistics at the highest political level. 

• Every child born in India is to be considered a Ratna – a jewel and handled as such; some of them will go on to get the formal Bharat Ratna tag eventually. 

• Provide equal opportunities at the workplace: Provision of the following will go a long way in eliminating work and livelihood related anxieties making their way back home as domestic violence.

•  Right economic stimuli, 
• anticipating potential workplace disruptions, 
• supporting reskilling and retraining, and 
• decriminalizing entrepreneurial failure 
• Removes societal stigma around pregnancies - Stigma erodes self-worth and kills silently.

• Ensuring availability of timely data:

• Timely, disaggregated, multidimensional data helps immensely in ensuring collective well-being, physical, mental and social.
• Improving Educational outcomes: which requires a whole of life and whole of society approach, and measuring the outcomes that matter, regularly.

• An ill­educated, anxious population is a tinderbox, capable of self­harm as well as being kindling for malice­driven mobilization.