Note : The article deals with the issue of under-nutrition and not
over-nutrition which is also classified as malnutrition. But, the issue is
mentioned once in a comparative analysis.
In the year 2000, the UN agreed
to set up eight socio-economic development targets in the form of Millennium
Development Goals (MDG) which were to be achieved by 2015. Member nations
formed their development policies keeping in mind these objectives. One of the
eight goals aimed at halving the number of undernourished people.
The year is 2014 and the UNDP
online portal reads a countdown of 1.29 years to the MDG deadline. Having had a good surge in economic growth
points, India’s report card on the MDG, specifically the one I mentioned above
is poor. As of the 2014 UNMDG report, one-third of the poorest in the world,
live in India. Poverty in itself happens to be a big issue, rather the largest
one, which we shall assess separately. Poverty is the precursor or rather the
cause to malnutrition. It increases the vulnerability of marginalised groups
due to limited or no income bases. An official publication ‘Towards Achieving
MDGs – India 2013’ puts the proportion of underweight children at 40% in
2005-06 down from 43% in 1998-99. While this development may be classified as
positive, it is extremely slow. The UNDP portal classifies this progress as
off-track. The Global Hunger Index ranks India 16 among 56 countries that have
a serious hunger situation with India classified in the alarming category. This
trend puts a big question on the ability of the state to achieve the set target
of 26% by 2015, which by rational thought can be determined as impossible in
the current scenario.
Looking for reasons
The nation that emerged from
partition 67 years back was one that had been economically ruined by its
rulers. This disadvantage was carried on by the infantile government of the
independent state. New development policies were plagued again by the huge
population base, inherent implementation lockouts, lack of financial sources,
the bureaucracy etc. A tremendous growth in population stifled the reduction in
poverty and malnourishment numbers. Now, high rates of poverty have existed in
India along with high growth rates since the beginning of the new millennium.
This is reflected in the fact that Indian society has now grown more
economically polarised – the rich have grown richer while the poor still live
on the fringes. Due to this factor, malnutrition exists not only among the poor
but among the wealthy urban populace too in the form of over-nutrition and
obesity. Hence, present-day India is a state with high numbers of
under-nourished citizens existing alongside a rapidly growing obese population.
While poverty forms the cynosure of discussion, there is a peculiar trend that
needs to be brought to light- while India was able to reduce its poverty
targets (living on less than $1 a day) to 23.9% by 2013 from estimated 35% in
the late 1990s and is expected to meet the target of 20.74% by 2015, the same
is not the case with malnutrition and hence the issue needs to be looked at in
a more detailed manner.
Another cause is poor healthcare;
the low number of skilled personnel available in neonatal units has not only
lead to high Infant Mortality Ratio but to the dubious distinction of India
holding almost half of the underweight children under 3 in the world. Moreover,
healthcare reforms are slow and their execution near to none. Now, remember
that around 60% of the population in the country still resides in rural areas
which are deficient in the basic services even today. So any health programs, while carefully acted
upon in urban zones, cannot be mirrored in the villages. Not only lack of
health facilities at birth, but poor sanitation during growth has led to
increasing stunted growth among the vulnerable children. Open air defecation,
lack of potable water leads to the body prioritizing infection-fighting to
brain development and growth.
Religious and cultural beliefs
are addendums that magnify the effects of poverty on malnutrition. In India,
several people do not consume animal meat and/or dairy products based on their
religious beliefs. This tends to deny them animal protein which cannot be
supplemented and substituted for by a cereal diet which forms the staple in
rural India. This puts such low-income and absolute-poverty groups at extreme
risks.
While religion contributes as a
big factor, gender bias flares its ugly head in this situation too. It has been
found that families normally tend to favour the male child in terms of access
to nutrition and healthy food. This stems from the fact that India has been a
patriarchal society historically. So, while women have suffered economically
and socially, they are even discriminated against in the basic requirements for
a healthy life.
Note: Shamefully, India is a country where female foeticide and
infanticide is still practised not only among the poor but in rich and educated
families too.
Fighting hunger
The task of cutting down such
numbers and eradicating under-nourishment in a country with a massive
population of over 1.2 billion is too daunting a task. But, the government of
the nation has taken up the challenge with increasing expenditure on welfare
programs in health, nutrition and sanitation and several missions.
The Mid-day Meal scheme is a
program by the Govt. of India to provide adequate nutritious food to school
going students around the nation by giving free lunch in schools fully or
partially funded/aided by the state. This scheme, though the largest of its
kind has been plagued with corruption and inefficiency of implementation. In a
majority of occasions, the food is found to be at a sub-par nutritional value. Giving
power to local bodies hasn’t helped due to several glitches in execution. The
PDS, or Public Distribution System in India provides for highly subsidised
grains to low income and poor families from government run shops. In recent
times, several ration shop owners have been caught diverting grain to private
shops to earn profits. Moreover, the government keeps a large buffer stock, a
significant part of which is wasted due to improper storage conditions. This program
too has suffered due to reasons similar to the ones faced by the Mid-day meal
scheme. In 1975, a program called the Integrated Child Development Services was
launched to target the health and nutrition of women and children under the age
of six. It has a wide reach covering almost 34 million children as of now.
Other significant steps include – National Rural Health Mission (2005-2012),
National Plan of Action for Children and efforts by the UNICEF and UNDP.
Several NGOs have been forerunners in bringing the schemes to the people,
especially the Mid-day meal scheme.
Taking the Fight Forward
India is a welfare state. The
problem here isn’t a lack of state machinery, but its inefficiency, narrow
target area and crippling. The government has allocated Rs. 132,150,000,000 for the Mid-day meal scheme alone for the
fiscal year 2013-14. This staggering amount, if spent in a targeted and
effective way could be beneficial in reducing under-nourishment at a landslide
rate. While India has a decentralized model in place for implementation of such
schemes, the executive has rendered even this model ineffective. Some practical
methods need to be evolved to bring the scheme on the right track. Dry food can
be used in mid-day meal schemes for it is easy to make, store and preserve for
longer periods without compromising on the nutritional values. Local
procurement of grains and cooking by local self-help women groups can be a good
measure. These SHGs can include women from the oppressed classes too. Since
several cases of caste discrimination have been reported in the Mid-day meal
scheme, an inclusive program will help tide over such caste-centric feeling.
Regular training programs for teachers who act as local monitors for the scheme
can be implemented by the state education authorities. The onus of
implementation lies on the monitoring committees and the executing groups. A
several tiered system though in place has failed to keep a check on the faults
often sweeping inconsistencies under the carpet. Independent monitors can be
appointed from time to time to verify and audit claims of the state appointed
committees.
Developments
in the public distribution system have been more promising, with the government
having agreed to increase the compensation to ration shop owners, more shops
being opened in far off places and storage shelters being improved. Such a
massive scheme requires a huge budget and upgrade of the entire infrastructure
for which the government has earmarked a considerable sum. Widespread targeting
will require more resource mobilization by the government in the coming years,
but at the steady pace that we are currently going it seems achievable.
Another
cause of worry is poor sanitation. India has the largest population of openly
defecating citizens in the world. This shameful distinction is one that the PM
has recently mentioned in his speeches. The first task is to provide for clean
toilets and water in the schools across the country. A small initiative after
installing the infrastructure would be to carry out awareness drives and
workshops to train children and teachers to mutually share the responsibility
to keep them clean. Make active participation of student-teacher bodies in
maintaining cleanliness in schools an integral activity of the curriculum – for
what is this but a lesson on your own responsibility as an individual to the society.
This civic responsibility awareness drive will go a long way in not only
creating clean schools but a cleaner India. Several states have already
announced massive execution schemes to come up with toilets in schools and
economically weaker sections of villages and cities. It is now to see how
competently such schemes are enforced.
Culturally
and socially, the society needs to be the active torch-bearer of reforms for
gender and caste equality. Local communities, RWAs, NGOs must advise and
conduct door-to-door sensitization programs to reduce bias especially against
the girl child. We are still clinging to social norms that are millennia old.
The public needs to realize that society too must move forward as time
progresses or it will only harm itself and in doing so destroy its weakest.
Constitutional and statutory safeguards will only deter people but not change
their mind-set. Hence, it is the elders
and the educated that must show the way.
At
the end of next year, India will face its final UNMDG attainment analysis. If steps
aren’t taken immediately we will have failed on this count, not to mention the
other seven. India is a populous nation and is poised to overtake China within
the century. Several cynics argue that this is a hindrance to our development.
I disagree. Today India has 65% of its population under the age of 35 which is
a huge advantage to its developing economy. But, the harsh reality shows that a
major chunk of this population, especially in the under 18 group, faces
under-nourishment. While poverty continues to be a plague, the state and
society can together provide a mechanism in which even the poorest gets two
square meals a day. It is a dream that was envisaged by our founding fathers
and is yet to be realized. It is a motive that drives the multi-billion welfare
schemes and, it should be the aim for us, the citizens and the government to
realize this dream by 2020.
- Anurag Arya
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