Insights into Editorial: For nutrition security: On undernourishment
The UN’s State of Food Security and Nutrition in the World report for 2017 has important pointers to achieve Nutrition policy reform. At the global level, the five agencies that together produced the assessment found that the gains achieved on food security and better nutrition since the turn of the century may be at risk.
Although absolute numbers of people facing hunger and poor nutrition have always been high, there was a reduction in the rate of undernourishment since the year 2000. That has slowed from 2013, registering a worrying increase in 2016.
Malnutrition: A Global Epidemic:
The estimate of 815 million people enduring chronic food deprivation in 2016, compared to 775 million in 2014, is depressing in itself, but more important is the finding that the deprivation is even greater among people who live in regions affected by conflict and the extreme effects of climate change. In a confounding finding, though, the report says that child under-nutrition rates continue to drop, although one in four children is still affected by stunting.
These are averages and do not reflect the disparities among regions, within countries and between States. Yet, the impact of the economic downturn, many violent conflicts, fall in commodity export revenues, and failure of agriculture owing to drought and floods are all making food scarce and expensive for many. They represent a setback to all countries trying to meet the Sustainable Development Goal on ending hunger and achieving food security and improved nutrition.
What is more, the Centre recently said it had received only 3,888 complaints on the public distribution system (PDS) over a five-year period. All this shows that the Centre and State governments are woefully short on the commitment to end undernourishment.
Malnutrition in India: A Snapshot
The state of hunger and malnutrition in India is worrying. Statistics compiled by the Food and Agricultural Organisation (FAO) show that while the Sub-Saharan countries of Africa have the highest prevalence of hunger, in absolute terms, India has the highest number (one quarter) of undernourished (hungry) people in the world (194.6 million or 15 percent of India’s total population during 2014-16).
Hunger and undernourishment lead to severe problems. Children and youth in this state suffer from numerous nutritional deficiencies which adversely impact their overall health. In India, data for 2015-16 show the following:
- 38 percent of children below five years (urban: 31%, rural: 41%) are stunted (low height for age);
- 25.6 percent (urban: 23%, rural: 23%) are wasted (low weight for height);
- 36 percent (urban: 29%, rural: 38%) are underweight (low weight for age);
- 2 percent were overweight in 2006 (above normal weight for height); and
- 58 percent of children aged between 6 and 59 months (urban: 56%, rural: 59%) are anaemic.
Malnutrition in children under-five also results in nearly half of the 1.3 million deaths occurring in the country each year. Among India’s adolescents, the proportion of overweight and obese was estimated at 11 percent and two percent, respectively, in 2007. Data on anaemia show that 56 percent of young girls and 30 percent of young boys in the age group of 15-19 years are anaemic.
Much more vulnerable in Tribal areas:
According to NFHS 2015-16, every second tribal child suffers from growth restricting malnutrition due to chronic hunger. Such acute food insecurity in tribal households is due to a loss of their traditional dependence on forest livelihood and the State’s deepening agrarian crisis. Besides these, systemic issues and a weakening of public nutrition programmes have aggravated the problem.
For example, 20% of tribal families did not receive rations (public distribution system) in Vikramgad (in Palghar, Maharastra) as they did not have a card.
India’s efforts at improving access to food and good nutrition are led by the National Food Security Act. There are special nutritional schemes for women and children operated through the States. In spite of such interventions, 14.5% of the population suffers from undernourishment, going by the UN’s assessment for 2014-16. At the national level, 53% of women are anaemic, Health Ministry data show.
Further, nutrition interventions and tracking progress cannot be done without sufficient information and reliable, updated data, and the operationalisation of a national nutrition surveillance system. Thus, there exists the need to collect and maintain real-time data on various nutrition indicators using ICT and GIS.
Institutions such as the State Food Commissions have not made a big difference either. Distributing nutritious food as a public health measure is still not a political imperative, while ill-conceived policies are making it difficult for many to do this. The report on nutritional deficiency should serve as an opportunity to evaluate the role played by the PDS in bringing about dietary diversity for those relying on subsidised food.
A critical aspect of nutrient adequacy is “diet diversity”, calculated by different groupings of foods consumed with the reference period ranging from one to 15 days.
The Energy and Resources Institute (TERI), being a multidisciplinary organization committed to sustainable development, has made a humble effort to help achieve this by designing and implementing a replicable model that includes optimal use of easily available minimal local resources incorporating traditional knowledge while encouraging communities to inculcate the best nutritional practices.
It is recommended that each person should have diverse diet of at least eight food groups, that include: cereals, roots and tubers; legumes and nuts; dairy products; flesh foods; eggs; fish; dark green leafy vegetables; and other fruits and vegetables.
This low dietary diversity is a proxy indicator for the household’s food security too as the children ate the same food cooked for adult members. It is time the government looks at the root cause of the issue and finds a sustainable solution for tackling malnutrition.
This is possible only when the state focusses on inclusive development by creating employment opportunities for the marginalised which would improve their purchasing power, diversify their diet and, in turn, reduce malnutrition.
In a report issued two years ago on the role played by rations in shaping household and nutritional security, the NITI Aayog found that families below the poverty line consumed more cereals and less milk compared to the affluent. Complementing rice and wheat with more nutritious food items should be the goal.