India's Turning Point in the Fight Against Child Malnutrition
WHY YOU SHOULD CARE
Because millions of India’s children are still malnourished.
By Amy Kazmin
Santoshi Kumari was an 11-year-old schoolgirl whose impoverished parents depended on state-subsidized rice to keep their family fed. Last year, however, the family lost access to India’s public distribution system, which gives rations of staple foods to the poorest, when they failed to link their ration cards to the government’s new biometric identification program.
Six months later, Santoshi died. It was during a school holiday, when she had no access to another critical source of nourishment, a government scheme that provides midday meals to children in state-run schools. Her parents say their daughter starved to death and that her last words were a plea for rice. Authorities deny she died from hunger, instead blaming malaria, although they confirm that her family had not received food rations for months.
Whatever the cause, Santoshi’s death was a powerful reminder of the pervasive hunger suffered by millions of young Indians, which overshadows their childhoods, compromises their futures and hampers the country’s economic prospects.
India might be touted as an emerging superpower, but millions of its children are still malnourished — the result of unhealthy diets, poor sanitation and their mothers’ own bad health and low social status. Malnutrition threatens not only children’s physical well-being but their mental development too.
The road ahead is daunting, but I’m more encouraged now than I have been before.
Purnima Menon, International Food Policy Research Institute
“Ninety percent of our brain develops in the first two years of life,” says Dipa Sinha, a convener of India’s “Right to Food” campaign. “The nutrition and stimulation you get then determine your learning ability, your future productivity and your long-term physical health.”
For many children, chronic malnutrition begins in the womb, with 20 percent having a low birth weight. That is the consequence of pervasive nutritional deficiencies in Indian women: About half of the country’s women of childbearing age are anemic.
According to India’s 2015–16 National Family Health Survey, 38 percent of under-5s (some 50 million children) are stunted, meaning their height is significantly below the normal range for their age. That is down from 48 percent 10 years previously but is still far higher than in many poorer countries. The survey also stated that 21 percent of children under 5 years of age are wasted — or significantly underweight for their height — a sign of recent acute hunger.
The results are disastrous for society. Studies have shown that malnutrition and hunger negatively affect children’s behavior and performance at school, impeding their ability to grasp even basic skills — a situation with severe repercussions for a country that is looking to harness its youthful population to propel the economy. “India has this demographic dividend,” Sinha says, “which we are losing now.”
All told, the World Bank estimates that malnutrition costs India’s economy $12 billion per year in lost productivity and higher health care spending. New Delhi is not indifferent: For years the government has funded vast supplementary food programs, which ostensibly provide extra food to mothers, infants and toddlers as well as midday meals for schoolchildren. Yet it is unclear how much of this assistance reaches the intended recipients, or whether the most vulnerable members of a family benefit from it. In poorer families, young girls in particular are often allowed less food than their male siblings, and what they do get to eat is often of a lower nutritional quality.
Even when food programs function well, Sinha says, access to a balanced diet is a big challenge for poor families. Handouts mostly take the form of cereals, which provide calories but not enough protein or micronutrients for healthy growth.
“We’ve moved away from conditions of starvation except in very backward areas, but Indian diets are very cereal-based, with very little fruit, vegetables or protein,” Sinha says. “Fruit and vegetables are not cheap, milk is expensive, eggs and meat are expensive.”
Despite the problems, many civil society activists and health professionals believe India is at a turning point. In December the government approved a national nutrition mission, a $1.4 billion, three-year effort to battle malnutrition through better integration and stronger monitoring of government programs that affect young children, as well as adolescent girls and mothers. The campaign will be monitored by high-level bureaucrats and is expected to give local officials greater incentive to ensure programs are carried out properly and help states identify weaknesses.
The mission has set aggressive targets for reduction of stunting, anemia and low birth weight babies. It will monitor food programs and other initiatives, including the national campaign against open defecation, a practice that contributes to malnutrition by encouraging the spread of diarrhea and internal parasites.
“The minute you really get people paying attention to what is happening on the ground and having reviews, things actually start moving,” says Purnima Menon, a senior researcher at the International Food Policy Research Institute. “You have to put all the pieces together,” she says. “I see quite a bit of energy in the central government toward really starting to roll this out. The road ahead is daunting, but I’m more encouraged now than I have been before.”
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