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Business News/ Politics / Policy/  Economic Survey calls for improving nutrition and sanitation
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Economic Survey calls for improving nutrition and sanitation

Low-cost maternal and early-life nutrition and sanitation programmes will help capitalize on India's demographic advantage, says survey

Photo: MintPremium
Photo: Mint

New Delhi: India needs to invest more in improving nutrition among children to capitalize on the demographic advantage offered by its young population, the annual Economic Survey said.

Low-cost maternal and early-life nutrition and sanitation programmes offer high returns on investments and present an opportunity for fiscal- and capacity-constrained governments, the survey said.

It identified open defecation as a source of early-life diseases in India. Enteric infections of the intestine, transmitted through contaminated water, impede childhood development. Evidence suggests that open defecation leads to child stunting and diarrhoea. Households whose members do not defecate in the open have higher height-for-age scores. Elimination of open defecation by 2030 is part of the UN’s Sustainable Development Goals.

According to a joint monitoring programme of the World Health Organization (WHO) and the United Nations Children’s Emergency Fund, 61% of rural Indians defecated in the open in 2015. It is far more than in other South Asian nations like Nepal (37.5%), Pakistan (21.4%) and Bangladesh (1.8%).

The survey said income constraints may not be the main determinant of open defecation, indicating that it may also be a behavioural issue. After building 8 million toilets under the Swachh Bharat mission, the next challenge that the government faces is in bringing about behaviour change in rural India to persuade people to start using toilets.

However, some experts believe that the argument around behaviour is blown out of proportion. “It is about quality of the toilets. Some are extremely flimsy and not fit for use. In my work for over a decade I have heard complaints about quality. Women in rural India are keen to use toilets as they find it difficult to openly defecate," said Sanjay Joshi, CEO, Shanti Life India Foundation, an Ahmedabad-based not-for-profit organization, working in the field of rural sanitation.

Improving nutrition in young children needs a multipronged approach in which the mother’s health and nutrition has to be an equal priority, according to the survey.

In India, where social norms accord low status to young women in joint households, women’s health itself gets heavily compromised.

Indian women do not gain enough weight during pregnancy. Women in India gain an average 7 kg during pregnancy, compared to the 12.5-18 kg recommended by the WHO.

The survey said that out of all infants who die in India, 70% die in the first month. A leading cause of this is low birth weight.

Women who are underweight at the beginning of pregnancy are far more likely to give birth to low weight babies. Nearly 42% Indian women are underweight at the beginning of pregnancy, in contrast to 35% of non-pregnant women of child-bearing age being underweight.

The National Food Security Act, 2013, (NFSA) gave cash entitlement to pregnant women of at least 6,000 aimed at improving nutrition during pregnancy. It is in this context that the Survey recommended pairing cash transfers with education about the benefits of gaining weight during pregnancy.

“Civil society is really pleased to see the kind of attention that maternal and child nutrition has received in the Economic Survey. However, cash benefits to pregnant women under NFSA should be unconditional. Putting conditions such as good behaviour of women, which includes consuming enough nutritious food, is a problem," said Jasodhara Dasgupta, senior adviser with Lucknow-based non-profit Sahayog. She said structural reasons like discrimination against women in households and compulsion to work due to acute poverty don’t allow women access to nutrition and conditions imposed by the government will be detrimental for them. “Cash transfers to pregnant women have not started yet. NFSA should be implemented soon," she said.

Additionally, the survey pointed out that early-life conditions affect cognitive development and, hence, nutrition at that stage is important to gain demographic dividends.

The survey noted that there has been a decrease in stunting in children in India. The National Family Health Survey 2005-06 showed that 48% of Indian children were stunted, which declined to 38.7% by 2013-14, according to the Rapid Survey on Children by the ministry of women and child development.

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Published: 26 Feb 2016, 03:51 PM IST
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