New Delhi: Much to India’s shame and despite three decades of state-sponsored child welfare schemes, every second toddler in the country is underweight, indicating insufficient nutrition, says a new study.
As many as 46% of Indian children below the age of three are underweight even after three decades of the government implementing the Integrated Child Development Services, or ICDS, scheme, according to a research by New Delhi and Jaipur-based Educational Resource Unit, or ERU.
“You cannot tackle malnutrition in a parallel, ministerial way,” said Vimala Ramachandran, who conducted the study. “Each individual ministry is like a horse with blinkers, looking only at its own concerns. You need a broader, more coordinated approach to this problem.”
Reality check: A study by Educational Resource Unit says it is wrong to blame poverty for malnutrition, which is also prevalent among the relatively better-off sections of Indian society. (Photo: Ramesh Pathania/ Mint)
Ramachandran based her analysis on India’s third National Family Health Survey (NFHS-3), which released its results in 2005-06. “Children’s nutritional status in India has improved slightly since NFHS-2 by some measures, but not by all measures,” the survey had said.
“Children under three…are less likely to be too short for their age today than they were seven years ago, which means chronic undernutrition is less widespread, but they are slightly more likely to be too thin for their height, which means acute undernutrition is still a major problem in India,” the survey had acknowledged.
Ramachandran’s research busts some popular myths about malnourishment.
“The biggest myth is that malnutrition happens because there is no food available,” she said. “Instead, it’s lack of time or proper care on the part of the parents that leads to infrequent feeding. Another myth is that only children from the poorest-of-the-poor sections of society suffer from malnutrition. In fact, there are malnourished children in the last 50-60% of the population, when ranked according to the wealth.”
She quoted, as a part of her research, a 2007 study by Prema Ramachandran of the New Delhi-based Nutrition Foundation of India.
The study’s counterintuitive finding on nutritional status across India further supports ERU analysis.
For instance, Prema Ramachandran had found that Karnataka, despite being considmore prosperous than Andhra Pradesh, had a higher percentage of underweight children.
On the other hand, states in the North-East, such as Arunachal Pradesh, Nagaland, Manipur and Mizoram, had some of the lowest child malnutrition rates in the country.
“Some states, such as Punjab and Haryana, are prosperous, but they are not exhibiting commensurate improvements in nutrition levels,” said Prema Ramachandran.
“They may have Honda City cars, but their women don’t breastfeed enough, or most women still deliver at home...there is inadequate natal care. It’s very wrong to put economics and poverty as drivers of undernutrition.”
Factors such as water, sanitation and public health, too, play a role, says study. “While there is recognition of the need for a multi-pronged approach, departmental turfs have been impossible to overcome,” Vimala Ramachandran said.
“As a result, in a village or urban slum, the people in charge of water and sanitation, public health, fair price shops, child nutrition, immunisation, treatment of illnesses and so on, have not worked together.”
She cited one example of ministerial parallel processing. India’s National Rural Employment Guarantee Act, or NREGA, mandates that if “the number of children below the age of six years accompanying the women working at any site are five or more, provisions shall be made to depute one of such women (sic) worker to look after such children.”
“But how often does that happen, how often is that enforced?” Vimala Ramachandran asked.
“If children are left unattended by their labourer parents, they are not fed every three hours, as they should be, and they wind up eating mud. So, that becomes an undernutrition problem, even though NREGA and its mandates fall under the ministry of rural development.”
The research also cautions against a single, Indiawide nutrition strategy. “India is a land of tremendous diversity. One strategy or one programme template cannot work across the country.”
“Given different social and economic situations, and different environmental and ecological terrain, and given different political and administrative culture, what India really needs is local and very context-specific planning.”
ERU, a private consulting group, conducts research studies, evaluations, and reviews in primary education, women’s education, rural livelihoods, social security, primary health care and women’s health.