National Nutrition Week 2018: Understanding Malnutrition in India
By: Shreevidhya Ravi
Published On: September 04, 2018
In this year's National Nutrition Week 2018 theme, we look at the causes of malnutrition in India and analyze whether the rates have increased or decreased. Read on...
India’s child malnutrition rates have steadily decreased since 2006. The proportion of underweight children has fallen from 42.5% a decade ago, to just under 30% now. Similar improvements have been found when it comes to stunting, wasting and other parameters of malnutrition.
These faster developments reflect progress that promises hope and growth for the future of our country. However, the progress is still not adequate to achieve the global nutrition targets set by World Health Assembly (WHA) to which India is a signatory.The cultural differences in India has made changing the landscape of nutrition a complex process
India is still behind when compared to some it's African counterparts. At current rates of decline, India will achieve the current stunting rates of Ghana or Togo by 2030 and that of China by 2055.
Additionally, the nutritional status and developments in India has a challenging dynamic; the differences and cultural compositions of Indian states has definitely made the changing landscape of nutrition in India, very complex.
Malnutrition in India state wise: Have the rates increased or decreased?
Tripura and Himachal Pradesh on the right to improve stunting
Among states, Tripura and Himachal Pradesh have been making strides in the right direction by improving the rates of stunting and underweight children since 2005-2006 according to National Health Family Survey (NHFS).
During the last NHFS in 2016-2017, Tripura has moved up three places to occupy the third position, after Kerala and Goa- two states with the lowest levels of stunting, in India. Himachal Pradesh has moved up five positions over the same period to now stand at the fifth position among states ranked with regard to levels of stunting.
Punjab and Chattisgarh struggle to tackle the issue of underweight children
While Punjab and Chattisgarh have also seen significant improvements in stunting over the past decade, they haven’t had great improvement when it comes to tackling the issue of underweight children.
At the same time, Andhra Pradesh and Karnataka also struggle to tackle both issues of underweight and stunting rates, and they have slipped down the ranking quite a bit.
Uttar Pradesh, Bihar and Madhya Pradesh account for most of India’s undernourished children
Central India lags behind the most when it comes to battling these issues actively. While states such as Uttar Pradesh, Bihar and Madhya Pradesh, have made some progress, it hasn’t been adequate especially when compared to other states.
They continue to be among the worst states in terms of rates of underweight and stunting. They also continue to account for most of India’s undernourished children, as they did a decade ago.
Malnutrition in India facts: Rates lower in urban areas
It is interesting to note that overall urban child malnutrition rates are lower than that of rural India.
The districts ranked in the bottom according to child malnutrition rates includes some of the more urbanized districts of the country such as Udaipur in Rajasthan, Aurangabad in Maharashtra, Lucknow in Uttar Pradesh, Patna in Bihar, and Ranchi in Jharkhand.
It is curious to see that malnutrition is not just limited to the prominent tribal belts but that it extends beyond that into urbanized Indian belt.
Why a nutritious meal is vital
It is no secret that nutrition, as an indicator has a lot to offer to the development of any country. India is set to grow at a rakish pace as of the most developing economies in the world.
For India to reach its full potential, focusing on battling malnutrition cannot be just an option anymore. Humans have managed to conquer space while we still proclaim that malnutrition puzzles us.
The policies and actions taken to tackle grassroots problems associated with nutrition is inextricably tied to how healthy, productive, scoopful and active the growing population associated with a country will be.
In the past, investments in nutrition-related health policies have reaped rich dividends. Ensuring that a country is well on its way to impacting poverty, literacy, gender imbalance positively would mean that the nutrition and health should be on top of the country’s agenda.
1: Good Nutrition can mean sustainability of food production
Agricultural and production of food is the inextricably tied to diet and nutrition. Food production uses 70% of freshwater supply. Additionally, 38% of world’s land is used for agricultural purposes.
Current practices associated with agriculture produce 20% of all greenhouse gas emissions. Ensuring that we eat better is definitely tied to making sure that the food production systems grow more sustainable.
2: Good nutrition can mean less dependence on health systems
Good nutrition directly impacts the health and well-being of a population. Ensuring that the population can get good nutrition can mean that people don’t depend too much on the country’s health infrastructure.
Especially in developing countries, this can make a huge difference given the fact their medical network and health infrastructure is still more on the evolving side.
3: Good nutrition can lead to equity
Having access to quality nutrition can mean that people will spend less time being sick or diseased, thus allowing them to take part in engaging with the socio-economic system better.
Thereby supporting inclusion while acting as a platform for better outcomes in employment, poverty reduction, education equity etc.
It is important to be aware of the fact that well-nourished children are 33% more likely to escape poverty as adults, and each added centimeter of adult height can lead to an almost 5% increase in wage rate.
Children who are less affected by stunting early in their life have higher test scores on cognitive assessments and activity level.
Due to malnutrition, the losses accounted were worth at least 8% of the global gross domestic product in the 20th century because of “direct productivity losses, losses via poorer cognition, and losses via reduced schooling”, according to medical journal The Lancet.
Needless to say, the losses are higher for high-burden countries such as India.
What can we do to eradicate malnutrition as soon as possible?
Malnutrition if ignored, can prove to be an inter generational problem in the sense that malnourished children are more likely to perform poorly in school due to the lack of cognitive development.
After the school phase passes, they are more likely to lose out on the competitive market due to the fact their lack of skill set or their development is not as expected and that in turn leads to them earning lesser incomes.
Lack of access to economic resources might push them into poverty and when they have a child, this cycle continues.
In order to be able to regulate its landscape, India needs to understand the differences that can plague its policy, at a sub national level. It is imperative to look at state level target setting for nutritional outcomes, both qualitatively and quantitatively, for tackling the malnutrition problem in India as it is tied to various multi-faceted objectives.
1: Focus on women health and empowerment
In spite of women constituting nearly half the population, the shackles of socio-economic barriers continue to let them stay disadvantaged.
Right from lack of primary education to sanitary conditions, the plight of women, especially in the lower income communities are extremely sad.
The vicious cycle continues; women being asked to quit school, being pushed into early marriage and having kids while they are barely 17-18 years of age with bare-minimum knowledge of pregnancy or health related issues.
They aren’t too sure how to take care of the kids or they don’t have the means to take care of the kid as they themselves are maln.
Lack of awareness and rampant gender discrimination leads to the serious neglect of women’s health and its related policies, which in turn shows up prominently when it comes to nutrition landscape.
Planning and implementing a series of awareness and education drives can definitely help in bridging the nutrition problem at its start.
2: Focus on administrative efficiency
As discussed before, different states in India come with their own unique problems. Along with that comes their own socio-cultural factors, economic reach and income inequality.
It is important for the central government to coordinate with the state government, for that enables the processes to be bind together, seamlessly.
When there is a lack of transparency and accountability between various levels of government, implementation becomes a whole lot tougher,especially keeping in mind the stark difference in rural and urban governance in our country.
Therefore, it is important to consider the needs of different countries and matching them up to the required health initiatives, rather than coming up with one directive that ties them all together.
3: Focus on sustainable food practices
Sustainable farming methods and agricultural habits is extremely important when it comes to shaping the landscape of nutrition. One cannot ignore the fact that when people learn to consume responsibly, there’s more available for everyone.
Reducing food wastage and educating the public on waste segregation are two ways in which one can ensure that healthy food practices are developed from the start.
Combating malnutrition is definitely the need of the hour, considering how India struggles to catch up with the standards set by WAH, it is imperative that we start early and sustain the efforts for as long as it takes to eradicating malnutrition in our country.
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