India sees worrying rise in malnutrition cases among children under 5

A girl eating on a sidewalk puts her food out of reach from a cow rummaging for food along a street in Noida on Dec 7, 2020. PHOTO: AFP

NEW DELHI - Malnutrition appears to be deepening in a worrying trend for the South Asian country, already home to the highest number of malnourished children in the world.

According to the recently released findings of the National Family Health Survey 2019-2020, conducted before the pandemic, over a dozen out of 22 states surveyed recorded an increase in underweight and severely wasted children under the age of five.

In the state of Maharashtra, for instance, children who are severely wasted, a way of gauging malnutrition, went up from 9.4 per cent in 2015-2016 to 10.9 per cent in 2019-2020.

Experts said it was difficult to pinpoint any single reason for the current increase in malnutrition levels and pointed to a combination of factors such as a slowing economy and growth in joblessness well before the pandemic. Growth had touched a six-year low of 4.7 per cent in the final quarter of 2019.

Though the data available is limited, experts were not surprised that malnutrition would follow on the heels of slower economic growth, said Dr Purnima Menon, senior research fellow at the International Food Policy Research Institute.

This despite the Poshan Abhiyaan, the government's flagship programme to improve nutritional outcomes for children, pregnant women and lactating mothers which was launched in March 2018.

The survey looked at 307,554 households in 22 states. Data for the other 14 states were disrupted by the pandemic and are set to be released next year.

It had some positive news in that the infant mortality rate (IMR) and that of children under the age of five has come down in 18 states. In the southern state of Andhra Pradesh, the IMR went from 34.9 per cent to 30 per cent.

India has the largest child population at 472 million but also faces the problem of one in three children being malnourished.

Malnutrition is seen to be caused by a range of factors including livelihood disruptions, over-dependence on cereals, poverty, low literacy, poor sanitation and lack of clean drinking water.

In 2012, then Prime Minister Manmohan Singh called high malnutrition rates among children a "national shame".

According to the Global Nutrition Report 2018, 46 million children in India are stunted, meaning they are short for their age, because of malnutrition, and 25.5 million are wasted, or dangerously thin.

There are concerns that the coronavirus pandemic will further deepen the crisis as it has led to disruption to government programmes like free school meals and free immunisation.

Free midday meals are provided in government schools across the country as a way to bring poorer students into the school system. But schools have been forced to shut due to the pandemic.

Some states have started delivering meals or cash for meals to students' homes.

The government as part of a coronavirus pandemic economic package also provided 5kg of rice or wheat to the poor. But these measures will not be enough, said non-governmental groups.

"Covid is going to make it worse due to non-function of services and deepening of livelihood insecurities. Malnutrition is going to go up," said Mr Sachin Kumar Jain, a representative of the Right to Food Campaign.

The problem of malnutrition is not an isolated issue for India or South Asia. What happens in India also impacts global efforts to end all forms of hunger and malnutrition by 2030, one of the UN Sustainable Development Goals.

Experts believe India needs to adopt a series of measures including integrating poverty alleviation programmes with nutrition.

"India's nutritional strategy needs to now fully bring in the importance of poverty alleviation work that lies ahead. Poverty and food security have to accompany the nutrition agenda. That's how acceleration can happen and close equity gaps," said Dr Menon.

Mr Jain noted: "Only government programmes won't be able to help us beyond a point. We need an integrated community-based approach which means giving more space for community leadership. For instance, if I go to a tribal community they use their own word for nutrition in their dialect. We never communicate in their dialect and that's why we are not able to put forward the message."

He added: "If India doesn't manage this problem, it means the globe will not eliminate malnutrition."

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