Malnutrition in India

Malnutrition in India

Significance of Zero Hunger

• The reason for mapping hunger is to ensure that the world achieves “Zero Hunger by 2030”— one of the Sustainable Development Goals (Goal 2) laid out by the United Nations.
• Although, achieving zero hunger requires not only addressing hunger, but also the associated aspect of malnutrition i.e food and nutrition security.
  • World Food Day is observed annually on October 16 to address the problem of global hunger.

Status of Malnutrition in India

• The Food and Agriculture Organization (FAO) estimates that 194.4 million people in India (about 14.5% of the total population) are undernourished.
• India ranks 102 out of 117 countries in the Global Hunger Index 2019.

NOTE: Global Hunger Index is based on three leading indicators:

• Child undernutrition: The prevalence of wasting and stunting in children under five years of age.
• Child mortality: rate under five years of age.
• Inadequate food supply: The proportion of undernourished in the population.
• Within South Asia, Sri Lanka, Nepal, Bangladesh and Pakistan are all ahead of India.
• Further, there has been dismal progress from last year ranking in the Global Hunger Index, in 2018 India ranks 103 out of 119 countries.

• According to the Indian Council of Medical Research (ICMR), in 2017, malnutrition was the predominant risk factor for death in children younger than five in every state of India.
• According to the Global Burden of Disease Study 2017, malnutrition is among the leading causes of death and disability in India.

What are the reasons for prevalent malnutrition in India?

• Monoculture agricultural practices: While foodgrain production has increased over five times since Independence, it has not sufficiently addressed the issue of malnutrition.
  
  • This is because, for long the agriculture sector in India focused on increasing food production, particularly staples (wheat and rice).
  • This led to lower production and consumption of indigenous traditional crops/grains, fruits and other vegetables, impacting food and nutrition security in the process.
  • This intensive monoculture agricultural practices can perpetuate the food and nutrition security problem by degrading the quality of land, water and the food derived through them.
• Changing food patterns: Food consumption patterns have changed substantially in India over the past few decades, which has resulted in the disappearance of many nutritious local foods, for example, millets.
• Poverty: Though poverty alone does not lead to malnutrition, it affects the availability of adequate amounts of nutritious food for the most vulnerable populations.
• Lack of sanitation and clean drinking water: Lack of potable water, poor sanitation, and dangerous hygiene practices increase vulnerability to infectious and water-borne diseases, which are direct causes of acute malnutrition.
• Migration: Seasonal migrations have long been a livelihood strategy for the poorest households in India, as a means to access food and money through casual labour.
  
  • However, children and women are the most affected, suffering from deprivation during migrations impacting their health condition.
• Gender injustice: There is a correlation between gender discrimination and poor nutrition.
  
  • Malnourished girls become malnourished adolescents who marry early and have children who become malnourished, and so the cycle continues.
• Lacunae at policy level: There is a lack of real-time data that brings all these factors together to show the extent of India’s malnutrition.
• Lax implementation: Providing nutritious food to the country’s children is more a matter of political will and effective policy implementation at the grassroots level.
  
  • For example, the Acute Encephalitis Syndrome (AES) outbreak in Bihar marked the failure of the Integrated Child Development Scheme (ICDS) in the state.

Government Schemes to Tackle Malnutrition

• Integrated Child Development Services (ICDS) Scheme
  
  • The scheme provides specific interventions targeted towards the vulnerable groups include children below 6 years and women.
  • It is being implemented by the Ministry of Women and Child Development.
  • It provides a package of six services namely supplementary nutrition, pre-school non-formal education, nutrition & health education, immunization, health check-up and referral services.
• National Health Mission (NHM)
  
  • National Health Mission (NHM) was launched by the government of India in 2013.
  • It subsumed the National Rural Health Mission and the National Urban Health Mission.
  • It is being implemented by the Ministry of Health & Family Welfare.
  • It was further extended in March 2018, to continue till March 2020.
  • The main programmatic components include health system strengthening in rural and urban areas for – Reproductive-Maternal- Neonatal-Child and Adolescent Health (RMNCH+A), and Communicable and Non-Communicable Diseases.
• Mid Day Meal Scheme
  
  • It was launched in 1995 as a centrally sponsored scheme.
  • It provides that every child within the age group of six to fourteen years studying in classes I to VIII who enrols and attends the school shall be provided with a hot cooked meal, free of charge every day except on school holidays.
  • The Mid Day Meal Scheme comes under the HRD Ministry’s Department of School Education and Literacy.
• Indira Gandhi Matritva Sahyog Yojna (IGMSY)
  
  • The scheme aims to contribute to a better enabling environment by providing cash incentives for improved health and nutrition to pregnant and lactating mothers.
  • It is being implemented by the Ministry of Women and Child Development
• National Nutritional policy 1993
  
  • The National Nutrition Policy (NNP) was adopted under the aegis of the Ministry of Women and Child Development.
  • The strategy of NNP was a multi-sectoral strategy for eradicating malnutrition and achieving optimum nutrition for all.

Way Forward

• Multi-sectoral approach: Substantial improvements across malnutrition indicators in the states of India would require an integrated nutrition policy.
  
  • These improvements include providing clean drinking water, reducing rates of open defecation, improving women’s status, enhancing agricultural productivity and food security, promoting nutrition-sensitive agriculture.
  • Integrated nutrition policy can be brought by harmonization of efforts across ministries, political will and good governance.
  • Such coordinated efforts will ensure that essential nutrition services reach the most deprived communities.
• National Nutrition Mission (POSHAN Abhiyaan) seeks to ensure a “malnutrition free India” by 2022.
  
  • POSHAN Abhiyaan which is India’s flagship program, envisages improving nutritional outcomes for children, adolescents, pregnant women and lactating mothers, is a step in the right direction.
  • However, it would require long-term investments in health, sanitation and nutrition in preventing deaths due to severe acute malnutrition.
• Decentralisation: Panchayats should be allowed to have a bigger say in running welfare schemes.
• Diversification: Public Distribution System should be diversified, to include millets.
• Strengthen MGNREGA to ensure better food security.
  
  • MGNREGA can play a vital role in mitigating the disastrous effects of droughts in rural areas.