Need to mitigate malnutrition crisis

Sunita Vakil

Scientific evidence suggests that compared with the risk’s a well nourished child faces, the risk of death from common childhood diseases is doubled for a mildly malnutrition child, tripled for a moderately malnourished child and may be even as high as eight times for a severely malnourished child. That malnutrition is a severe health issue in India needs no reiteration

The fact that child malnutrition is far more widespread in India than in China and Brazil speaks poorly for a nation that touts its high rate of economic growth and fancies itself as an aspiring superpower.

Even as India economy has grown tremendously in the past decade, child malnutrition in the biggest challenge the country is facing today. We may have made impressive strides in a myriad of areas like space exploration, IT sector and stem cell research but development is meaningless if we cannot ensure the health of our children.

Unfortunately, the levels of child malnutrition in India are extremely high. Though comparisons do not serve for much, the very fact that child malnutrition rate in India is worse than in China and Brazil reflects the government’s failure to help provide its people, especially the young, with the nutrients needed to build healthy, productive lives.

Quality of health

More than anything else, India’s high levels of child malnutrition speak a lot about the continuing neglect of health, the poor quality of health services and inadequate reach and efficacy of health and child care services. And, this despite the fact that the country has had the Integrated Child Development Program, in place for more than 30 years.

The Prime Minister has often spoken about inclusive growth. But such dismal development indicators clearly suggest that there is something very wrong with the government’s strategy of combating child malnutrition.

Though the Indian Government spends more on child nutrition programs than any other country in the world, the trickle down effect of various targeted intervention programs is abysmally poor.

Nutrition level

It is a sad commentary on the state of affairs that despite numerous policies and programs that have been in place for years, India has not achieved decent nutrition levels. Over 38 percent of our children are stunted and 15 percent wasted while the underweight prevalence rate is a shocking 43 percent, as revealed by WHO data.

This clearly points to the fact there has been no determined action on the part of the centre as well as State governments consequently, the issue has remained unaddressed because it is not high on national agenda.

That the government is continuing with its biased, callous and thoughtless policies while being grossly indifferent to people’s needs is a matter of shame. Indeed, these are real issues that need to be tackled head on by making them a State priority.

For all the progress India has made it has an astonishingly bad record of reducing malnutrition. The country accounts for nearly 40 percent of the world’s malnourished children. It is deeply unfortunate that more than 450 children under the age of six have died of severe malnutrition across Madya Pradesh since May 2008. These figures do not sit well with a nation that dreams of emerging as an economic superpower on the world stage. And the worst past is that these deaths occurred despite several special schemes like Bal Shakti Yojana, the Shaktimaan Yojana, the Bal Sanjeevani Abheiyan and many others having been in place.

Sadly, this indicates administrative failure besides lack of political well. It would make better sense to strengthen such schemes to make them more result oriented and meaningful.

State attention

It is for the government to take stock of the serious situation and give child health the full fledged State attention that it rightly deserves. Malnutrition is a medical condition caused by an improper and inadequate diet and nutrition.

According to WHO, hunger and malnutrition are the single gravest threats to the world’s public health and malnutrition is by far the greatest contributor to child mortality.

Malnutrition and mortality

Scientific evidence suggests that compared with the risk’s a well nourished child faces, the risk of death from common childhood diseases is doubled for a mildly malnutrition child, tripled for a moderately malnourished child and may be even as high as eight times for a severely malnourished child. That malnutrition is a severe health issue in India needs no reiteration.

The country is long known to have some of the highest rates of child malnutrition and mortality in under fives in the world. We may crow about being a country with one of the youngest populations in the world but the government has miserably failed to discharge its fundamental responsibility to millions of children who continue to remain hungry, malnourished and sick.

There may not be a simple explanation for India’s alarming malnutrition rate but a slew of factors like the rising number of urban poor, the poor state of public Health Services and floundering welfare schemes can be listed as the major underlying causes.

Spiralling food prices and an ineffectual government threaten to make things much worse in the coming years.

In fact, a 2005-06 government study has revealed that hardly any progress has been made in reducing child malnutrition over the last decade and half. A large section of the population still suffers from hunger.

That one out of every 5 Indians suffer from hunger or semi-starvation is well documented. Indeed, India is a classical example of how planned economic development has not got translated into food security at the household level. It is this chronic food insecurity in the country that has been a major contributor to child malnourishment.

Further, also effecting the health and nutritional well-being of the children is the high prevalence of anemia and other micro-nutritional deficiencies. As a resent, 20 percent children have a low birth weight.

The states with the highest number of underweight children are Madhya Pradesh, Jharkhand and Bihar. They are followed by Gujarat, Orissa and Chhattisgarh. Ignorance and frequent infections also play a major role in contributing to child malnutrition.

Though hunger and food deprivation are still pressing problems in India, a crumbling Public Health system provides a vital clue to the alarming child malnutrition rate in the country. Notwithstanding the fact that India operates the largest child feeding program in the world, it has failed to make any substantial progress.

Although efforts to target malnutrition have been in place for several decades, it has fared much worse than other countries with comparable socio-economic indicators.

The reach of ICDS has been limited because of the serious mismatch between intentions and implementation.

Further, child feeding practices education and counselling of mothers, material health care services and service delivery systems have not received the desired attention.

Multiple factors

Haking said that, there is a lack of integrated strategic approach for addressing the challenge of malnutrition. Since multiple factors influence the child’s nutritional well-being the need of the hour is to take a multi dimensional approach. For starters, there is a dire need to step up nutritional intervention schemes on a war footing.

The ICDS system also needs to be implemented more effectively to make it result-oriented.

There is much the government can do to reverse such dismal indicators by bringing down the prices of nutritious food so that even the poorest can afford it.

The public distribution system also needs to be strengthened to ensure that most essential items reach the deprived sections at an affordable cost.

The strategy for prevention and management of malnutrition must equally address issues like access to safe drinking water, medication and a clean hygienic environment.

Last but not the least, the answer also lies in enhancing the women’s health status and promotion of gender equality.