A new report, ‘Food and Nutrition Security Analysis, India, 2019’, authored by the Government of India and the United Nations World Food Programme, paints a picture of hunger and malnutrition amongst children in large pockets of India. 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.

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Reasons for malnutrition in India:

• Mother’s health:
  • Scientists say the initial 1,000 days of an individual’s lifespan, from the day of conception till he or she turns two, is crucial for physical and cognitive development.
  • But more than half the women of childbearing age are anaemic and 33 per cent are undernourished, according to NFHS 2006. A malnourished mother is more likely to give birth to malnourished children.
• Social inequality:
  • For example, girl children are more likely to be malnourished than boys, and low-caste children than upper-caste children.
• Sanitation:
  • Most children in rural areas and urban slums still lack sanitation. This makes them vulnerable to the kinds of chronic intestinal diseases that prevent bodies from making good use of nutrients in food, and they become malnourished.
  • Lack of sanitation and clean drinking water are the reasons high levels of malnutrition persists in India despite improvement in food availability.
• Lack of diversified food:
  • With the increase in diversity in food intake malnutrition (stunted/underweight) status declines. Only 12% of children are likely to be stunted and underweight in areas where diversity in food intake is high, while around 50% children are stunted if they consume less than three food items.
• Lack of food security:
  • The dismal health of Indian women and children is primarily due to lack of food security.
  • Nearly one-third of adults in the country have a body mass index (BMI) below normal just because they do not have enough food to eat.
• Failure of government approaches:
  • India already has two robust national programmes addressing malnutrition the Integrated Child Development Service (ICDS) and the National Health Mission but these do not yet reach enough people.
  • The delivery system is also inadequate and plagued by inefficiency and corruption. Some analysts estimate that 40 per cent of the subsidised food never reaches the intended recipients
• Disease spread:
  • Most child deaths in India occur from treatable diseases like pneumonia, diarrhoea, malaria and complications at birth. The child may eventually die of a disease, but that disease becomes lethal because the child is malnourished and unable to put up resistance to it.
• Poverty:
  • The staff of ICDS places part of the blame of malnutrition on parents being inattentive to the needs of their children, but crushing poverty forces most women to leave their young children at home and work in the fields during the agricultural seasons.
  • Regional disparities in the availability of food and varying food habits lead to the differential status of under-nutrition which is substantially higher in rural than in urban areas. This demands a region-specific action plan with significant investments in human resources with critical health investments at the local levels.
• Lack of nutrition:
  • Significant cause of malnutrition is also the deliberate failure of malnourished people to choose nutritious food.
  • An international study found that the poor in developing countries had enough money to increase their food spending by as much as 30 per cent but that this money was spent on alcohol, tobacco and festivals instead.

Challenges to fight malnutrition:

• 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.

Measures needed:

• Availability:
  • 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.
• Accessibility:
  • 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.
• Utilisation:
  • Storage capacity should be improved to prevent post-harvest losses.
  • There is a need for more robust measures that can take cognizance of all aspects of SDG 2.
  • All the major welfare programmes need to be gender sensitive.
  • The inherited dehumanising poverty explains the persistence of malnutrition on a large scale.
  • Children born in impecunious circumstances suffer the most from malnutrition. It is all the more reason for governments to intervene to provide adequate nutrition to all.
  • Funds for food to all yield great returns and help in unlocking the full potential of citizens besides strengthening the workforce.

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 Mukth Bharat (Malnutrition Free India).