Rashida, 22 sits rocking her two year old son Kashib, who looks barely more than two months old. Kashib is severely malnourished, cannot talk or walk, whimpers while awake and sleeps the rest of the time.

Rashida looks equally frail and stares despondently at us and then the child. Their sheer hopelessness is the story of many like Rashida in the Tonk district of Rajasthan.

Poor pay with life and more

"I feed him biscuits and tea, he doesn't eat anything else. We took him to the doctor who asked us to take him to Jaipur. Where is the money to pay the doctors when we can barely manage food for the family?" laments Rashida, "We can only do as much as our means allow."

Poverty is a grinding and grim reality for many in rural Rajasthan. A good harvest depends almost entirely on good rainfall and in turn the family income and savings. Even available health services are a distant dream for most.

Tonk, largely populated by Muslims, is the antithesis of India's much hyped prosperity. Men are engaged in traditional craft of embroidery - not so profitable and a dying art.They often have to take work as rickshaw pullers or daily wage labours. Most women in the community are engaged in bidi rolling.

"My husband leaves very early. He carries heavy loads on his back which give him blisters. We have children to take care of. If he doesn't work we will starve," says Wahidunisan, 35, and a mother of three children.

Cultural barriers tread on children's lives Rukhsana, 35, lost two babies to pneumonia within 24 hrs and three days of life, respectively. While family size is large , any form of birth control is not an option for Wahidunisan and many of the Muslim women in her community.

"It is God's will. Children are blessings from Allah. Sometimes it's a bad spell that takes our children's lives," said Amin Mohammad, Wahidunisan's father-in- law moving rosary beads between his fingers.

As Amin left his wife Habibunishan says in a hushed tone, "Men in the family would not allow, but I tell my daughters-in-law to take pills to avoid pregnancy. How would they know?"

In a family of 20 children there are more girls than boys. When asked if they send the girls to school, Habibunishan answered, "My sons were not willing. I said at least they will be better off than their mothers if they go to school and it will do them some good."

The age old fatalism and lack of education combine to make women and children suffer and succumb to deaths, which in most cases can be prevented by extremely simple treatments.Many children in the area have died either of pneumonia or diarrhea, many more live in dire need of nutrition to make them last. Most women continue to deliver babies at home with the help of traditional midwives or even pay a female nurse from the nearby health centre.

"There are male doctors in the hospital. We don't feel comfortable in front of them," said Rukhsana, 35, and mother of five.It has been just two months since she delivered the youngest who is suffering from diarrhea while reeling from pneumonia.

Sometimes there is no money for treatment, while at other times they don't realise the severity of the situation which in turn delays treatment leading to death.

Despite government efforts, why are children still dying?

It is the mix of myths, lack of awareness, and poor health services that account for needless deaths of mother and children.

Indian government's schemes - National Rural Health Mission (NRHM) and Integrated Child Development Services (ICDS) were thought to be relevant responses to India's burgeoning health problems. However, these government policies have failed to reduce the numbers of children dying in India fast enough.

"While India's public expenditure on health remains abysmally low , in some places financing for child nutrition programs remains unspent because there is such a lack of demand for the services. In effect, well-meaning programs have fundamentally failed to deliver.Partly because there is no inbuilt mechanism to monitor how effective or not the programmes have been," said Shireen Vakil Miller, Advocacy and Policy Director, Save the Children India.

Reports reveal that on an average 13 children die every hour in Rajasthan before their first birthday. Moreover, one woman loses her life every hour in the state due to complications arising out of pregnancy and child birth.

"Health and survival of mothers and their new borns are intrinsically linked and solutions have to go hand in hand if we are to reverse the trend," adds Miller.