Multi-dimensional determinants of malnutrition

Mother’s health:

    • Scientists say the initial 1,000 days of an individual’s lifespan, from the day of conception till he or she turns two, is crucial for physical and cognitive development.
    • But more than half the women of childbearing age are anaemic and 33 per cent are undernourished, according to NFHS 2006. A malnourished mother is more likely to give birth to malnourished children.

Social inequality:

    • For example, girl children are more likely to be malnourished than boys, and low-caste children than upper-caste children.


    • Most children in rural areas and urban slums still lack sanitation. This makes them vulnerable to the kinds of chronic intestinal diseases that prevent bodies from making good use of nutrients in food, and they become malnourished.
    • Lack of sanitation and clean drinking water are the reasons high levels of malnutrition persists in India despite improvement in food availability.

Lack of diversified food:

    • With the increase in diversity in food intake malnutrition (stunted/underweight) status declines. Only 12% of children are likely to be stunted and underweight in areas where diversity in food intake is high, while around 50% children are stunted if they consume less than three food items.

Lack of food security:

    • The dismal health of Indian women and children is primarily due to lack of food security.
    • Nearly one-third of adults in the country have a body mass index (BMI) below normal just because they do not have enough food to eat.

Failure of government approaches:

    • India already has two robust national programmes addressing malnutrition the Integrated Child Development Service (ICDS) and the National Health Mission but these do not yet reach enough people.
    • The delivery system is also inadequate and plagued by inefficiency and corruption. Some analysts estimate that 40 per cent of the subsidized food never reaches the intended recipients

Disease spread:

    • Most child deaths in India occur from treatable diseases like pneumonia, diarrhoea, malaria and complications at birth.
    • The child may eventually die of a disease, but that disease becomes lethal because the child is malnourished and unable to put up resistance to it.


    • The staff of ICDS places part of the blame of malnutrition on parents being inattentive to the needs of their children, but crushing poverty forces most women to leave their young children at home and work in the fields during the agricultural seasons.
    • Regional disparities in the availability of food and varying food habits lead to the differential status of under-nutrition which is substantially higher in rural than in urban areas.
    • This demands a region-specific action plan with significant investments in human resources with critical health investments at the local levels.

Lack of nutrition:

    • Significant cause of malnutrition is also the deliberate failure of malnourished people to choose nutritious food.

An international study found that the poor in developing countries had enough money to increase their food spending by as much as 30 per cent but that this money was spent on alcohol, tobacco and festivals instead.