–Kakali Das |
The National Family Health Survey (NFHS) 2019-20 report shows that 17 states in India have seen an increase in cases of malnutrition in children under 5 years of age. The NFHS data reports the first five years of the Modi government; Telangana, Kerala, Bihar, Assam, and the Union Territory of Jammu and Kashmir reported an increase in child wasting and stunting, whereas states such as Maharashtra and West Bengal have been at the same level. The first phase of the survey shows that the several states have witnessed ‘meagre improvement’ or ‘sustained reversals’ in child malnutrition parameters such as child wasting, share of children underweight and child mortality – the four key metrics are used in several global indices such as the Global Hunger Index.
The topic of ‘Child malnourishment’ in India might not be interesting for many readers, but it is one that could topple progress in a country and thus needs to pay tremendous attention to. Based on numbers arising out of the National Family Health Survey (NFHS) shows, “India may be reversing decades of progress on child nutrition.” And based on what we have witnessed in this data on its primary trends, it shows that eighteen out of twenty-two states show an increase in the number of stunted, wasted or underweight children. Also, India oddly finds itself in a curious situation where economically we have even had a bit of growth in the last 5 years but our hunger numbers have worsened. “IMR improves in India, but malnutrition remains worrying”, shows NFHS-5.
In spite of the schemes like ‘Poshan Abhiyaan’, and the earlier governments’ focusing on malnutrition not much has been done to tackle it. 20% of the kids are under-nourished because their mothers are malnourished. The country is still lagging behind in valuing women, feeding and helping them in dealing with anaemia. It shows enormous insensitivity from a gender perspective. Under-nourished mothers give birth to under-nourished babies.
“Malnutrition in a child is determined primarily in between 6-18 months of its age. Why is it that we haven’t been able to use behavioural change or health information and reach out to each and every mothers to begin feeding the babies after 6 months? It just shows the lack of respect and value for girls and women in this country. I think it’s a national shame for India to be in this situation” – Poonam Muttreja, Executive Director, Population
According to reports, 38% of the children in our country are ‘stunted’ (low height for a certain age), meaning that one in every three children, counting even the ones in the rich families in big cities, are stunted in our country. ‘Wasting’ (underweight) in children is 21%, meaning one in every five children is wasted in our country. If I understand correctly, when we don’t feed our children between the ages of 0-5 years, their brains don’t develop strongly enough to compete to their full capacity. We are, actually, sentencing them to a lifetime of poverty, since they will, on no account, be able to compete with children who have been fed well enough in their primitive years. Feeding them adequately with proper nutrients or adequate micronutrients and vitamins that they require in order to grow is utmost essential. The poor have food security with wheat and rice by the government in the country, but is it adequate?
“What is now proved is that the damage in the first two years in a child’s life is irreparable. Whatever one may do afterwards to make up for it won’t be sufficient. Cognitive brain development or productivity as adults isonly attainable through proper nutrients in one’s body” – Neerja Chowdhury, Senior Journalist
The disease, Anaemia has surged up to 70% in states like Maharashtra and 80% in Gujarat. If 4 out of 5 children are anaemic today, what future would India hold! Efforts have been made through “Poshan Abhiyaan” to curb it, but impact of it have not been captured in a way that’s sufficient. Yet is unfair to say that the Abhiyaan hasn’t brought an impact; it has brought in huge energy, but that energy has exhausted a lot in creating visibility, rather than ground level programming, reviewing and monitoring that are necessary, and are the dull part of the work, but would have yielded more results.
“I think the time has come possibly to have a separate ministry for nutrition, and to put it right under the CM or the PM, so it gets that kind of importance that it needs to have. We need to be far more vigorous and determined than we have been before” – Neerja Chowdhury, Senior Journalist
Why is it that the endeavours that India has been doing for the last many decades have not shown any real results? This isn’t the problem of one government, but successive governments through decades. Integrated Child Development Services was introduced way back in 1975, which aimed to feed pregnant, lactating mothers and children below age 6. It’s that old a programme but the allocations which are made in budgets to ICDS are ridiculously low. ICDS should be catering to 17 crore population – 15 crore children and about 2 crore lactating and pregnant women. But the budget around 25 thousand crores across the country is a depressingly small amount, since it is a daily portion of nutrition to children and these women.
“Even if we look at the formula that the governments have in terms of making the allocation, we are at least expecting a sum of 50 thousand crores as the budget. Wheat and rice type of PDS system doesn’t provide enough protein; pulses which was used to be included along with sugar in the 70s have all disappeared from the PDS system. The primary healthcare approach is extremely weak in this country”, Ravi Duggal, Public Health Activist
“Tamil Nadu, Chhattisgarh are the states which does quite well in terms of providing nutrition to the children and women. Many North-eastern states invest enough in primary healthcare. They spend nearly 2-3% of their state domestic product spending 3000-4000 rupees per capita – which is a huge amount compared to the national average of only 800 rupees per capita in healthcare. All these are interrelated and integrated. You require the support of primary healthcare; you need enough food to be given through ICDS system for the small children so they get supplementary nutrition”, Poonam Muttreja further said.
Politics around food has overturned the core of the country, for an instance, Madhya Pradesh removed eggs from the menu of the ICDS and claimed that it was done on religious grounds. It’s evident that the boiled egg is the easiest way to give a child adequate protein per day.There are huge inefficiencies, corruption and poor governance even in the ICDS’s small budget programme. It’s completely a supply oriented programme, rather than a demand or need based programme.
In 2020, the the mid-day meal programme failed visibly, because the schools were closed; children who were receiving the mid-day meal were no longer getting hold of it. Merely increasing the budget in the future isn’t enough. What has failed the government is the lack of any commitment in running these programmes efficiently. “We are a scheming society; we roll out schemes but we don’t know how they function. ICDS is one of the programmes that have been evaluated unlike manyother programmes. It shows too many deficiencies, but we haven’t done enough to change or resolve it. The concept of ICDS is impressive, but we run it terribly.” – Poonam Muttreja
No matter how disappointing a news it is for the Indians, it hardly qualifies in the category of ‘news’ to be picked up by the mainstream media. Negligible importance in this topic has been placed in political reporting, political discourse, and not the kind of significance it should have been given. The media, too, is primarily at fault in the sense that it doesn’t provide enough visibility in a crucial news as such. The government, anyway, never feel the need to solve problems if there’s nobody crying about it.