Clearly, neither the UN’s Millennium Development Goals (MDGs) agreed upon by the Government of India in 2000, nor repeated alerts on the nation’s state of well-being back home, have had the desired impact. So, even as the economy has grown at a now widely acclaimed pace, a startlingly large and growing section of the population faces either hunger or malnutrition.
That growth and development don’t necessarily go hand in hand has, therefore, been highlighted in an exceptionally stark manner over the past few weeks and the major reason is inadequate and inefficient action by the state.
The recently released final report of the third National Family Health Survey (NFHS 3), the mid-point review of the MDGs and the International Food Policy Research Institute’s global hunger index, which together paint a worrisome picture, must be taken as an alarm bell—now, at the very least.
It is sad that NFHS 2, which had already pointed to a serious nutrition and health problem, did not lead to an adequate response—what we see is a worsening of the situation spelt out several years back.
The MDGs were signed in 2000. And a review tells us that not only are we are likely to fall short of the targets, we are also lagging behind several other developing countries including China and Vietnam.
Meanwhile, NFHS 2 reflects the status as of 1998-99, while NFHS 3 that of 2005-06. A comparison between the two surveys’ findings, therefore, does clearly reflect that intentions and goals have not translated into outcomes. As a result, both among women and children, the level of nutrition and health care seeking behaviour has worsened.
Wasting, or acute undernutrition, among children who are under three years has actually gone up from 15.5% to 19%. Anaemia, which is primarily linked to poor nutrition, has extended from 74% to 79% among this age group. In Madhya Pradesh, Bihar and Uttar Pradesh, the number is as high as 85%. Stunted growth, indicating chronic, long-term undernutrition, is still seen in 38% of the children against 45% at the time of NFHS 2. And the proportion of underweight children in this age group has barely declined from 47% to 46%. Naturally, on all counts, rural India fares far worse than urban. Even as the infant mortality rate has come down from 68%, we are still at an unredeeming 57%. On this front, we are even behind other South Asian countries such as Bangladesh and Nepal, as the MDG review reveals.
What is the significance of these numbers? As medical experts explain, malnutrition retards a child’s cognitive, physical and emotional growth, and makes him more susceptible to diseases. Needless to add, it hinders productivity later on.
Again, naturally, malnutrition is rising among women. Underweight and anaemic women give birth to infants with the same problems. From 50%, the share of pregnant women who have anaemia has gone up to 58% between the two national surveys. The figure for underweight women has fallen only slightly from 36% to 33%.
The question is why? We have, after all, apart from a range of social programmes, an ambitious initiative called the Integrated Child Development Scheme stipulating both nutrition and medical support for children and pregnant women. The answer lies both in the lack of inadequate resources allocated by the government and in chronic corruption hitting such schemes. The answer equally lies in the declining per capita availability of foodgrain and the acknowledged failures in the public distribution system.
What we also urgently need is recognition of hunger and malnutrition as major factors affecting the nation’s health. Neither our health nor our nutrition policy has delivered.
The recent alarm bells are surely a wake-up call.
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