Children in South Asia deserve better: a call for a South Asian child rights Manifesto

Introduction

South Asia continues to carry a disproportionate share of global child health challenges. The region accounts for nearly a third of the world’s stunted children, some of the highest neonatal mortality rates worldwide, and widespread child marriage, trafficking and hazardous labour.¹,³ Climate change, recurrent economic shocks and protracted conflicts further heighten children’s vulnerability by exacerbating food insecurity, disrupting essential health and education services and increasing exposure to displacement and violence, particularly in low-resource South Asian settings.⁴ The COVID-19 pandemic reversed years of progress, affecting immunisation, learning outcomes, mental health and household security.⁵

Despite these challenges, regional coordination on child rights remains limited. Across South Asia, child-focused national programmes frequently operate in sectoral silos, remain chronically underfunded and insufficiently address the interconnected determinants of health, education, protection and social welfare, limiting their overall effectiveness.^{1 6} Because children lack political voice, their needs are routinely overshadowed by competing governance priorities. Recognising this urgency, the South Asian Association for Prevention of Child Abuse and Neglect (SAPCAN) has developed the South Asian Child Rights Manifesto. A regional child rights framework can provide shared direction, harmonise standards, promote evidence-based policy and strengthen collective accountability.

Guiding principles: a rights-based approach

The Manifesto is grounded in the four foundational principles of the United Nations Convention on the Rights of the Child: non-discrimination, best interests of the child, right to survival and development and the right to be heard.⁷ These principles are particularly relevant to South Asia, a region characterised by entrenched gender norms, caste- and ethnicity-based exclusion, religious marginalisation, widespread poverty and limited disability inclusion, all of which intersect to shape children’s survival, development and access to opportunities from early life onward.^{1 6 8}

To translate principles into practice, the Manifesto calls for child-centred governance structures, increased budget allocations for child-related sectors and integration of child rights into constitutional and development frameworks. Evidence from multiple sources demonstrates that sustained investment in human capital—particularly child health, nutrition, education and protection—is associated with faster economic growth, improved population health, greater social cohesion and more sustainable development outcomes.⁹,¹¹

The thematic priorities outlined below were developed through a consensus-based process led by SAPCAN, informed by the Convention on the Rights of the Child, regional epidemiological evidence and expert consultations among paediatricians, public health specialists and child rights advocates across South Asia.

Right to survival and development

Although preventable child deaths have declined globally, South Asia remains a hotspot for neonatal and under-five mortality.^{2 12} Malnutrition—stunting, wasting and micronutrient deficiencies are major concerns, with South Asia bearing 40% of the global burden of stunting; impairing cognitive development and increasing lifelong health risks.^{1 13}

The Manifesto prioritises:

• The right to survive and grow up healthy, safe and with the opportunities to thrive.

• Universal maternal, newborn and child health services.

• Strengthened nutrition interventions across the life cycle.

• Expansion of immunisation, including new and underused vaccines.

• Early childhood development programmes.

• Integration of child and adolescent mental health into primary care.

• Leveraging digital tools to improve service delivery.

Progress in these areas can yield substantial economic returns while reducing intergenerational cycles of poverty.⁹

Education for all: quality, equity and inclusion

Despite improvements in enrolment, South Asia faces a severe learning crisis. While the vast majority of children do attend school, according to World Bank figures, 100 million in South Asia are ‘learning poor’, ie, not achieving minimum literacy and numeracy standards and more than 30 million children actually remain out of school.¹⁰ Gender norms, poverty, disability and geography remain major barriers to equitable education.

The Manifesto emphasises:

• Investment in quality teaching and digital learning.

• Safe, inclusive learning environments.

• Elimination of corporal punishment and school-based violence.

• Special attention to displaced, migrant and refugee children.

• Expansion of early childhood education.

Quality education is one of the most powerful tools for improving health and reducing vulnerability.

Protection from violence, abuse, exploitation and neglect

South Asia continues to report high rates of child marriage, trafficking, hazardous labour, online exploitation and gender-based violence.^{3 14 15} From available data, over 26 million children are engaged in child labour,³ and almost half of all child marriages globally originate from South Asia.¹⁴ Poverty, weak enforcement of laws and social norms contribute to persistent child protection failures.

The Manifesto calls for:

• Stronger legislation and law enforcement.

• Social protection schemes targeting vulnerable families.

• Trained child protection workforce at community level.

• Child-friendly reporting and justice systems.

• Safer digital environments, including monitoring of cyber-crime.

• Cross-border coordination against trafficking.

A robust protection system is essential for ensuring that children can grow and learn without fear.

Child participation and voice

Meaningful child participation remains limited in South Asia. Although governments increasingly acknowledge children’s voices, involvement is often tokenistic.

The Manifesto promotes:

• Creation of safe and inclusive spaces for children to participate in decisions at household, school, community and policy levels.

• Inclusion of adolescents in policy discussions, especially on climate, education and digital safety.

• Platforms for safe online participation.

• Training children in civic engagement and leadership.

Participation fosters empowerment and improves the relevance and acceptability of policies.

Environment, climate change and child rights

South Asia is one of the world’s most climate-affected regions. According to the Children’s Climate Risk Index, over 600 million children (nearly all children in the region) live in areas with high or extremely high climate risk, facing severe threats from heatwaves, floods, pollution and water scarcity. Heat waves, floods, droughts, air pollution, water scarcity and disease outbreaks disproportionately harm children.^{4 16}

The Manifesto advocates:

• Child-centred climate resilience strategies.

• Air pollution control, especially in urban hotspots.

• Safe water, sanitation and hygiene in homes and schools.

• Mental health support after climate-related disasters.

• Integration of climate literacy in school curricula.

Climate justice requires recognising children as frontline stakeholders.

Regional solidarity and cooperation

Child-related challenges such as migration, trafficking, epidemics and climate disasters transcend national borders. The Manifesto encourages:

• Regional surveillance and data-sharing systems.

• Joint public health and nutrition programmes.

• Cross-border child protection mechanisms.

• Collaboration between paediatric associations, academic institutions and civil society.

• Shared climate resilience planning.

• Revitalise South Asian Association for Regional Cooperation (SAARC).

A unified regional commitment can amplify impact and reduce duplication of efforts.

A call to action

The South Asian Child Rights Manifesto is both a vision and a practical advocacy tool. It urges governments, professionals and institutions across South Asia to adopt an evidence-based, child-centred approach grounded in equity and human rights. The Manifesto supports all actions aimed at promoting peace, regional stability and co-optation in South Asia, recognising that children are the strongest bridge to a more just, inclusive and united future.

Investing in children is not optional—it is fundamental to the region’s stability, prosperity and moral obligation. Children must be placed at the centre of policy decisions, not at the periphery. We call on researchers, clinicians, policymakers and civil society to join us in advancing this Manifesto and ensuring that every child in South Asia has the opportunity to survive, grow, learn and thrive.