The Indian Sundarbans, one of the world heritage sites, is a unique biosphere reserve of mangrove forests spread across more than a hundred islands. Most of the region is intersected by tidal rivers or estuaries and innumerable narrow tidal creeks, that make it a largely formidable and inhospitable terrain. In 2010, FHS-IIHMR came up first with a report highlighting the precarious health condition of its people, its health system and a plan for a better future. Among many other findings, the report evidenced that children of Sundarbans are the most vulnerable to health shocks due to unacceptable levels of under-nutrition and high prevalence of common communicable diseases.
The present report focuses on one of these more vulnerable blocks, namely Patharpratima, as a representative block of the Sundarbans. To understand the root of the problem, the study takes a child health right approach and attempts to understand whether and to what extent the rights are protected, especially in climatically challenged areas such as the Sundarbans. In a nutshell, this report generates research evidence on the barriers to service delivery and access of health care services for children and endeavours to find out ways to make the system more effective in the Sundarbans.
The study identifies a huge gap in the protection of child health rights in the Sundarbans, especially in the context of the thousand days window of opportunity for ensuring a healthy future of children. The key challenges to make the system more responsive to children's basic health needs are influenced by several factors working within the following five domains: Climate, Topography, Society, Livelihood and Formal health care structure. It is important to note that the challenges across the domains are not independent; rather, they work together and produce a strong spiraling effect to resist the development process, especially in the context of health sector initiatives. The time has now come to acknowledge the uniqueness of the health care needs of this region and focus on them with special attention.