Malnutrition in India

• 10 Jul 2019

This article is based on the editorial “The malaise of malnutrition”. It talks about the reasons and challenges associated with malnutrition in India

Modern-day India represents a paradoxical situation where a large section of society (the poorest two-fifths of the country’s population) is still largely untouched by the modern economy which the rest of the country inhabits.

Despite rapid economic growth, declining levels of poverty, enough food to export, and a multiplicity of government programmes, malnutrition amongst the poorest in India remains high.

According to the ‘Food and Nutrition Security Analysis, India, 2019’ report authored by the Government of India and the United Nations World Food Programme malnutrition amongst children in India is projected to remain high, despite all the progress made in food security.

• Some progress has been made in reducing the extent of malnutrition:
  
  • Chronic malnutrition decreased from 48% percent in 2005-06 to 38.4% in 2015-16.
  • The percentage of underweight children decreased from 42.5% to 35.7% over the same period.
  • Anaemia in young children decreased from 69.5% to 58.5% during this period.
  • However, many studies over the last five years have exposed the failure of the Indian state to ensure that its most vulnerable citizens are provided adequate nutrition in their early years.

Intergenerational Transmission of Poverty and Malnutrition in India

The report shows the poorest sections of a society caught in a vicious cycle of poverty and malnutrition which is passed on from generation to generation.

• Mothers who are hungry, anaemic and malnourished produce children who are stunted, underweight and unlikely to develop to achieve their full human potential.
• The lack of nutrition in their childhood years can reduce their mental as well as physical development and condemn them to live in the margins of society.
• These disadvantaged children are likely to do poorly in school and subsequently have low incomes, high fertility, and provide poor care for their children continuing the intergenerational transmission of poverty and malnutrition.

Malnutrition

• Malnutrition is a complex and multi-dimensional issue.
• It is primarily caused by several factors, including poverty, inadequate food consumption, inequitable food distribution, improper maternal, infant and child feeding, and care practices, inequity and gender imbalances, poor sanitary and environmental conditions, and restricted access to quality health, education and social care services.
• Malnutrition in India also persists because of the age-old patterns of social and economic exclusion.
  
  • Over 40% of children from Scheduled Tribes and Scheduled Castes are stunted.
  • Close to 40% of children from the Other Backward Classes are stunted.
• In April 2016, the United Nations General Assembly adopted a resolution proclaiming the UN Decade of Action on Nutrition from 2016 to 2025.
• The Sustainable Development Goal (SD Goal 2: Zero hunger) aims to end all forms of hunger and malnutrition by 2030, making sure all people – especially children – have access to sufficient and nutritious food all year round. This involves promoting sustainable agricultural practices: supporting small scale farmers and allowing equal access to land, technology and markets.

National Nutrition Mission

• The government launched National Nutrition Mission (renamed as Poshan Abhiyaan) in March 2018.
  
  • It aims to reduce undernutrition, anemia (among young children, women and adolescent girls) and low birth weight by 2%, 3% and 2% per annum respectively.
  • It also aims to reduce stunting (a measure of malnutrition that is defined as the height that is significantly below the norm for age) by 2% a year, bringing down the proportion of stunted children in the population to 25% by 2022.
  • The policy aims to map various schemes that address malnutrition and set up a robust convergence mechanism, and an information and communications technology-based real-time monitoring system, besides incentivising states and Union territories to meet the targets.
  • National Nutrition Mission is backed by a National Nutrition Strategy prepared by the NITI Aayog with the goal of attaining “Kuposhan Mukt Bharat" or malnutrition-free India, by 2022.
  • However, achieving this target will require doubling the current annual rate of reduction in stunting.
• Challenges related to National Nutrition Mission
  
  • Lack of coordination between various ministries affects the programme’s implementation.
  • The scheme also suffers from under-utilisation of allocated funds.
    
    • Till now, State and Union Territory governments have only used 16% of the funds allocated to them.
  • Lack of real-time data monitoring, sustainability and accountability also impact the National Nutrition Mission (NNM).
  • Anganwadis are key to the distribution of services to mothers and children. But many States, including Bihar and Odisha, which have large vulnerable populations, are struggling to set up functioning anganwadis, and recruit staff.
  • The Mission does not have differential approach to the issue of malnutrition, more focus is needed on the areas where malnutrition levels are comparatively high.
    
    • For example- the highest levels of stunted and underweight children are found in Jharkhand, Bihar, Madhya Pradesh, Gujarat and Maharashtra.

Way Forward

Key recommendations of the ‘Food and Nutrition Security Analysis, India, 2019’ report can be followed by India to curb the challenge of malnutrition.

Key Recommendations

• Farmers should be encouraged and incentivised for agricultural diversification.
• Innovative and low-cost farming technologies, increase in the irrigation coverage and enhancing knowledge of farmers in areas such as appropriate use of land and water should be encouraged to improve the sustainability of food productivity.
• The government should improve policy support for improving agricultural produce of traditional crops in the country.
• Storage capacity should be improved to prevent post-harvest losses.
• The targeting efficiency of all food safety nets should be improved, especially that of the Targeted Public Distribution System (TPDS), to ensure that the poorest are included.
  
  • In addition, fortification of government-approved commodities within the social safety net programmes can improve nutritional outcomes.
• Child feeding practices should be improved in the country, especially at the critical ages when solid foods are introduced to the diet.
  
  • Fortification, diversification and supplementation may be used as simultaneous strategies to address micro and macronutrient deficiencies.
• There is a need for more robust measures that can take cognizance of all aspects of SDG 2 which seeks to end hunger and all forms of malnutrition.
• All the major welfare programmes need to be gender sensitive.

Conclusion

As Amartya Sen noted, famines are caused not by shortages of food, but by inadequate access to food. For the poor and marginalised, access to food is impeded by social, administrative and economic barriers.

If India wants to be malnutrition free, it will not be achieved only through government intervention, but through a cultural revolution or Jan Andolan like Kuposhan Bharat Choro (Malnutrition Free India).

Drishti input
Malnutrition in India is a scar on India’s in pursuit of becoming a superpower. Discuss the reasons and challenges associated with the high level of malnutrition in India?