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Thursday, 18 September 2014

Hunger and Malnutrition : Challenge 2020

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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