India’s Malnutrition Problem

India, the second-largest food producer in the world. Despite, India is home to one-third of stunted(low height for age) children in the world. According to the Global Nutrition Report 2018, 46.6 Million children are stunted in India. Further, Global Nutrition Report 2020 says that India is among 88 countries that are likely to miss the global nutrition target by 2025. The report also says that 37.9% under 5 are stunted, 20.8 are wasted(low weight for height) which is more than Asia average 22.7&9.4 respectively. Nearly 52% of non-pregnant women are anaemic (iron deficiency).

In 2012, the United Nations adapted 17 Sustainable Development Goals(SDG) “to produce a set of universal goals that meet the urgent environmental, political and economic challenges facing our world”. The SDG 2 aims to end world Hunger by 2030. Despite decline in poverty levels in India, the prevalence of malnutrition is widened contararily.

Causes for Malnutrition

Government of India launched the Integrated Child Development Services (ICDS) program to provide food, preschool education, healthcare checkup, immunisation under 6 years of age and to mothers. In the tenth five year plan, Anganwadis were linked to ICDS. But ICDS proved to be ineffective by a study in 2005. However, the ICDS scheme was restructured in the 12th Five-year plan. For FY 2019-2020, ICDS was allocated 27584.34 crores.

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Anganwadis play a key role in rural areas and the centre is run by teachers. The Planning Commission evaluation report on ICDS puts some points on the ineffectiveness.

  • The teachers do have any educational qualification of 10th or 12 class and were very inefficiently trained to monitor and calculate the relevant children data.
  • Anganwadis check only children registered with centre. An estimated 50% of children were not registered with Anganwadis who’s monitoring goes unchecked.
  • Anganwadis have a scarcity of equipment and learning aids.
  • Referring ill-nourished children to the Nutrition Rehabilitation Centre(NRC) were hardly known to parents and admissions were being refused by NRC.
  • Poor data entry and relevant skills at the supervisor level. There is the high mismatch of data which is directly forwarded to govt. at this step.

Sanitation: According to UNICEF faecal contamination and poor sanitation are leading causes of childhood mortality, stunting, diseases and undernutrition. Lack of sanitation facilities and clean water increases malnutrition in children. Less than 50% population in India have access to safe water according to UNICEF. Also, The school dropouts in girls is due to the poor sanitation facilities in schools.

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Poverty: Poverty is one of the major reasons in India. The income of the family directly impacts the health status. According to the Human Development Index(HDI) report, 2019 India is home to 28% (364 Million) of the world poor. Further, a report by the World Economic Forum(WEF) titled Global Social Mobility Report 2020: Equality, Opportunity and a New Economic Imperative say that 220 million Indians sustained expenditure less than rs.32/day. less expenditure on food is directly proportional to the amount of calories,nutrients intake which is the significance for nourishment.

Income Inequality: Oxfam, the rights group reported that the top 1% rich in India holds 40% of national wealth. Nearly 68.8% of India’s population lives less than $2/day. Despite an increase in GDP the poverty still prevails in India. Income inequalities directly affect the consumption of food. The Public Distribution System(PDS) supplies rice/wheat. However, food supplies through PDS are very deficient in nourishment. Further, PDS left the majority of poor in remote areas for not having a valid document to enrol.

Demographic: The malnutrition is high in rural areas. Northern India has a high prevalence of malnutrition compared to the rest of India. Lack of connectivity is making fewer food supplies in remote areas.

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Gender: Female child is considered as a burden in villages. The domestic violence on girls is found to have an impact on both physical and mental health. The psychological problems were directly correlated to the underweight of women. The undernutrition will in turn have adverse effects on the childbirth. Also, the blind beliefs, superstitions and myths in rural areas are further deteriorating the health conditions of women and children.

Consumption patterns in india are traditional and regional. A diverse food habits or consumption pattern is not adequate. Indian food system ignores micronutrient supplies in consumption. Apart from major food source like wheat & rice, pulses cereals were less consumed. Parents education could do better in this aspect.

Environment & Climate change is the most ignored factor in children development. The environment conditions directly impact the well being of children. Environmental contaminants like air and water quality deteriorate health conditions. Children become vulnerable to diseases and other ill conditions easily when there is no appropriate living conditions.

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India launched an initiative POSHAN Abhiyan or National Nutrition Mission in 2018 to bringdown the malnutrition and eradication by 2022. As of October 2019, only 30% of the total funds released were utilised by states on average. The utilisation of funds determines the performance of the scheme. The below data was only available on Poshan Abhiyan scheme(my gov. portal). There was no clear definition of what does activity mean. However, the numbers are far below if we assume the numbers were to be meals served/persons .

However, it was all pre covid times. Now the situation is hard and worse. Lockdown period is really a nightmare to poor. Many lost jobs, income etc. It is all over the news about migrant people travelling on roads, hunger, deaths. The circumstances will further deteriorate the malnutrition level among poor women and children.

Increase in joblessness and poverty due to the pandemic will lead to a rise in hunger as well as malnutrition in the country. When poverty will increase, it will automatically result in food insecurity. Which means that many people will not have the money to buy food and will not be able to afford nutritious food. Another thing that we are worried about is the impact of COVID-19 on the services that were stopped during the lockdown. Even after the lockdown, which has been lifted in many parts of the country,  we saw that the immunisation rates are still not back to what they were before the COVID times. And then of course is the fact that the frontline workers and authorities  are busy trying to deal with COVID and identify people with COVID and helping them, in such a situation, importance on other subjects such as nutrition interventions is ignored.

UNICEF India chief for nutrition.

Malnutrition and child growth depends on multiple factors. An in depth study is necessary accounting multidimensional factors like environment,climate change and socio-economic,living conditions etc.

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