Malnutrition, especially in infants and children below three years, has plagued India like a malignant tumor for the last few decades. India even puts the sub-Saharan countries to shame as evident from the statistics that say every one in three of the world’s malnourished children lives in India, the largest democracy in the world.
A lot of factors contribute to malnutrition. Inadequate intake of food is just one of them. Malnutrition in early childhood causes severe impairments in motor, sensory and cognitive functions as well as in social and emotional developments. The death toll due to malnutrition is also appalling as evident from the fact that 50% of all the childhood demises occur in India. Some of the main factors responsible for malnutrition in children are vitamin and mineral deficiencies, anemia (affecting 74% of children under three), iodine deficiency, and vitamin A deficiency which results in blindness and a host of other diseases. All these deficiencies combined results in the high mortality rate among pre-school children. Other than that, low immunity power in undernourished children causes them to die from common childhood diseases like gastrointestinal and respiratory infections. Malnutrition turns out to be one of the major bottlenecks in fulfilling a lot of the aspirations of the Millennium Development Goals (MDGs) of the United Nations especially those related to ending child mortality.
Malnutrition is a complex problem involving a lot of other important factors like safe drinking water supply, proper sanitation, school education, agriculture and food and public distribution. Ousting malnutrition completely from our country is a Herculean task. It is one of the top agendas in the priority list of the present government and is now receiving proper attention at the highest levels. The government has envisaged a “multi sectoral approach” and “direct and specific interventions” to address the issue of malnutrition through the implementation of various schemes and programs through the state governments and the Union territory administrative systems. Some of these include:
1. Integrated Child Development Services (ICDS) specially programmed for lactating and pregnant mothers and children below the age of 3.
2. National Rural Health Mission (NRHM)
3. Mid Day Meal Scheme (MDM)
4. Rajiv Gandhi Scheme for Employment of Adolescent Girls( RGSEAG) SABLA
5. Indira Gandhi Matriyo Sahayog Yojana (IGMSY)
These are some of the “direct and specific interventions”. “Multi-sectoral approaches include:
1. Targeted Public Distribution System (TPDS)
2. National Horticultural Mission
3. National Food Security Mission
4. Mahatma Gandhi National Rural Guarantee Scheme (MGNREGS)
5. National Rural Drinking Water Scheme, etc.
All these schemes have been programmed keeping in mind their potential to address the maternal and child malnutrition issues. The National Food Security Bill (under proposal in Loksabha) will also help considerably to alleviate the malnutrition problem. Food Agriculture Organization (FAO) report, “The State of Food Insecurity in the World 2012” reveals that “17.5% of India’s population was estimated to be undernourished in 2010-2012 (down from 26.9% in 1990-1992 and 17.5% in 2010-2012)”.
However, in spite of the sincere efforts of the government, schisms exist between the government envisaged nutrition programs and their actual implementations due to various factors like lack of voluntary manpower in the different states. Madhya Pradesh has the highest malnutrition rate (55%) and Kerala the lowest (27%). Data collected by the DHS (Demographic and Health Surveys) indicate that in India 43% of the children are underweight, 48% of the children stunted due to malnutrition. Other studies reveal that one third of all adult women and 30% of newborns are underweight, a scenario far worse than the sub-Saharan countries that are technically much poorer than India. Malnutrition in children and pregnant mothers is not only a national shame but a resident evil that needs to be exorcised with the strictest of measures.