Stunted progress

Increasing malnutrition among children is worrying

Malnutrition, especially among children, is growing despite abundant availability of food and coverage of two-thirds of the country’s population under the National Food Security Act. This bitter truth has time and again been highlighted by various studies and surveys. The latest alert has come from the National Family Health Survey 2019-20 released by the health ministry. It shows that the proportion of children suffering from stunting (low height), wasting (underweight) and anaemia (emaciation) has risen perceptibly since the last such survey in 2015-16. Earlier, the Global Hunger Index 2020, released in October, had placed India at 94th position among 107 nations, in the “serious” hunger category, mainly because of rampant undernourishment and malnourishment (hidden hunger) among children below five. Insufficient and unbalanced nutrition results in poor physical and mental growth, leading to low productivity in adulthood. Research has suggested that 90 per cent of the brain grows by age five, so proper nutrition in the early years can make future decades 50 per cent more productive.

The health survey has revealed that the proportion of children suffering from stunted growth has gone up substantially in 11 states, severe wasting in 14 and anaemia in 17 out of the 18 states for which the data on these aspects was collected. Significantly, wasting, caused by acute food deficit and defined as insufficient weight for height, is believed to have exacerbated by varying degrees in most other states as well. One out of every five children in India is now underweight. The growth in anaemia cases is huge and worrisome. The rise since 2015-16 is estimated at 33 per cent in Assam and a massive 63 per cent in Gujarat, pushing up the total percentage of anaemic children to 68 per cent in Assam and 80 per cent in Gujarat. This reflects poorly on the country’s overall nutrition profile and food-related policies. Particularly worrying is the steady aggravation of the scourge of malnutrition and its occurrence in relatively richer states and amongst the well-off sections of population. The government’s flagship nutrition-oriented programme, the Poshan Abhiyaan or the National Nutrition Mission, launched in March 2018, too, has not begun to show results due mostly to inadequate emphasis on wholesomeness of the diets fed to children and mothers under its schemes.

The survey’s findings have significant policy implications. For one, a clear distinction needs to be drawn between hunger, which has more or less disappeared, and malnutrition (insufficient and unbalanced food intake) which still remains unaddressed. Even obesity is a form of malnutrition that leads to various health problems. Most of the country’s food supplementation programmes aim at augmenting food or calorie intake rather than ensuring balanced nutrition. The need, therefore, is to diversify the food items supplied through official schemes targeted at children and pregnant and nursing mothers. The food provided under the programmes like the mid-day meal scheme for school children and Anganwadi scheme for children and mothers should have a variety of items to constitute wholesome diets. This can be done by including millet, eggs, milk or fortified (nutrient-enriched) processed food products in the diets supplied under these programmes. Many of these changes in the food basket can be brought about without much additional cost. But if extra expenses have to be incurred on this count, it should not matter considering their far-reaching benefits.