Photo: Priyanka Parashar/Mint
Photo: Priyanka Parashar/Mint

India turns the tide on malnutrition

According to health experts, more than 50% of child mortality under five years of age can be attributed to malnutrition

A little less than a fortnight ago, the government released the first tranche of the National Family Health Survey (NFHS-4). Covering 13 states, it tells us that in the decade ended 2015-16, a large proportion of Indians have seen an improvement in their health.

More precisely, it tells us that one troubling health statistic, malnutrition, may be on the mend; especially since the health data pertaining to two of the states—Bihar and Madhya Pradesh—most afflicted with malnutrition show a perceptible fall. Of course, this has to be caveated by the fact that this is a relative assessment—against the fact that previously the decline of malnutrition was very sluggish—and it is not ‘Mission Accomplished’.

Far from it. The point here is that after several tweaks, public policy interventions, if the data is to be believed, are finally showing results on the ground. The trick is to quickly comprehend what interventions are working and promptly scale the programme. Much time has already been lost. This is because malnutrition is the silent assassin and is devastating to not just large swathes of the population but also to the nation’s economy—impacting productivity and creating an army of sick personnel. Because it is not easily visible, it is ignored, especially in rural India, and had consequently acquired frightening proportions.

Malnutrition is the single largest factor contributing to child mortality. It makes children fatally vulnerable to diarrhoea, malaria and respiratory infections. According to health experts, more than 50% of child mortality under five years of age can be attributed to malnutrition. And for those who survive, they remain vulnerable for the rest of their lives, which, in any case, cannot be normal—worse, they are just one illness away from plunging back into poverty or deeper into it as the case may be.

So, what is there in NFHS-4 that makes us hopeful so suddenly. The first batch of data released by the government only covers 13 states. Data on Madhya Pradesh and Bihar reveal that both for stunted and undernourished children less than five years, there have been a substantive decline. To be sure, the Rapid Survey on Children 2013–14 released last year signalled a visible improvement in malnutrition. NFHS-4 has only confirmed this trend.

In the case of Madhya Pradesh, undernourished children less than five years dropped from nearly two in three children in 2005-06 to a little over two in five children in 2015-16. In the same period, the decline was from 55.9% to 43.9%. This, by any standards, is a very significant fall.

What gives? I am sure health experts will dwell in detail on what worked this turn around. While that may be the case, there does seem to be some correlation between improved sanitation and decline in malnutrition.

The NFHS-4 (actually a treasure trove of health statistics and accessible at www.bit.ly/23BRwjh) shows that in both states there was almost a doubling of the population with access to improved sanitation. In the case of Bihar, it rose from 14.6% in 2005-06 to 25.2% in 2015-16 and for Madhya Pradesh, over the same period, it was up from 18.7% to 33.7%. At the least, it is a key factor contributing to the visible improvement in malnutrition in these two states.

If indeed this correlation does hold up to academic scrutiny, then it may well be providing ideological ballast to the idea of Swachh Bharat. This is an idea which seems to resonate (as Congress vice-president Rahul Gandhi found out the hard way during his interaction with students in Bengaluru when he chose to pan the programme) with most people.

In the final analysis, it is apparent that one aspect of India’s health status is on the mend. Eradicating malnutrition is a precondition for India to realize its economic potential. The country has turned a corner, but the battle is far from over.

As Ashok Alexander, director of Antara Foundation which seeks to provide preventive public health solutions, puts it: “We have come a long way, and there is an even longer way to go. Empowering the woman and enabling her good health is the surest way to tackle malnutrition."

Anil Padmanabhan is deputy managing editor of Mint and writes every week on the intersection of politics and economics.

Comments are welcome at capitalcalculus@livemint.com.

His Twitter handle is @capitalcalculus

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