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India's nutritional crisis

The fact sheets of the third round of the National Family Health Survey (NFHS-III), conducted in 29 States in 2005-2006, indicate that the health and nutrition status of India's women and children is in vast and systemic crisis. At the all-India level, 45.9 per cent of children below the age of three — that is, about 45 million little girls and boys — are underweight or malnourished in terms of the standard weight-for-age criterion. The corresponding proportion in 1998-99 was 46.7 per cent. The change over the intervening seven years in this key indicator of child malnutrition has thus been negligible. Among married women in the 15-49 age group, the prevalence of anaemia has risen from 51.8 per cent in 1998-99 to 56.1 per cent in 2005-06. No less than 57.9 per cent of pregnant women suffer from anaemia, which has also risen among children aged 6 to 36 months — 79 per cent were anaemic in 2005-06 compared with 74.2 per cent in 1998-99. There are of course wide variations across States in both levels and trends in indicators of health and malnutrition. While Punjab and Kerala report the lowest proportion of underweight children (27 per cent and 28.8 per cent respectively), in Jharkhand and Madhya Pradesh more than 59 per cent of children below the age of three were underweight. Child malnutrition has actually risen in seven States, most rapidly in Madhya Pradesh and Haryana.

The NFHS-III estimates of health and nutrition among women and children speak to India's present and its future. The failure of national policy affects not only this generation — as malnourished children are unlikely to reach their full human potential — but also the next, as anaemic and malnourished young girls are likely to grow into mothers who give birth to low birth weight babies. The provisional NFHS-III estimates of child malnutrition may be modified. Experts indicate, for example, that a shift from the present norms for child malnutrition based on National Centre for Health Statistics standards to new norms proposed by the WHO may lower the estimates of underweight children but raise the estimates of stunted children. Nevertheless, the overall picture of malnutrition among young children on a mass scale will not change. These results come as a grim warning to policy makers that high rates of economic growth alone will not bring about improvements in public health and nutrition. Many countries that are lower than India on the GDP ladder have taken better care of their children. The Central and State governments must make a comprehensive policy effort, backed by full financial commitments, to provide adequate nutrition and health care to every citizen and basic school education for every child in India.

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