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Despite the recent economic boom in India, at least 46% of its children up to the age of 3 still suffer from malnutrition making the country home to a third of the world’s malnourished children, says a recent study
Despite achieving robust economic growth in the last one decade, India is still home to the largest number of malnourished children in the world. To improve this dismal record the country needs to upgrade its governance system, says Lawrence Haddad, director of the UK-based Institute of Development Studies (IDS). The contrast between India’s fantastic economic growth and persistent malnutrition is shocking, points out a latest IDS study, incorporating papers by more than 20 India analysts and describing the country as an “economic powerhouse but a nutritional weakling”. The study says India is home to one-third of the world’s undernourished children, despite impressive economic progress with real GDP per capita growing by 3.95% annually from 1980 to 2005. Although the Indian government has committed to addressing the problem, a flawed delivery mechanism to provide nutritional food to children is the major bottleneck to overcoming this “urgent challenge”. “Normally, we expect economic growth and improved nutrition to go hand-in-hand, but at the current rate India will take at least 35 years to overcome the problem,” says Haddad, hinting that India would not meet the UN’s 2015 target for improving nutrition. The United Nations defines malnutrition as a state in which an individual can no longer maintain natural bodily capacities such as growth, pregnancy, lactation, learning abilities, physical work, and resisting and recovering from disease. All 192 UN member states have agreed to meet a string of developmental goals known as the Millennium Development Goals (MDGs) by 2015, including reducing malnutrition, poverty, child mortality and fighting epidemics like HIV/AIDS, TB and malaria. “By failing to reach this target, the Indian government is condemning a further generation to brain damage, poor education and early death that result from malnutrition,” Haddad says. The study titled ‘Lifting the Curse: Overcoming Persistent Undernutrition in India’ argues that the problem reflects a failure of governance at several levels of Indian society. It identifies a number of problems in nutrition service delivery. Services are not provided where they are needed. Some groups of citizens are systematically excluded from services. Services are of low quality. Accountability for service provision is weak. Leadership is fragmented. Awareness of the problem is poor. Year-on-year nutrition data is not available to enable monitoring of progress. Haddad says China -- which had started off with malnutrition rates of around 40% in the 1990s -- had already met the nutrition goals by cutting rates to about 15%, mainly through a more focused and innovative approach. As a result, he says, China was “two generations ahead of India”. India is home to more than 230 million undernourished people, with around 46% of children suffering from malnourishment. Experts say around 3,000 infants die in India every day from causes related to malnutrition such as a weak immune system. Haddad says: “Nutrition, it seems, is nobody’s responsibility. To its great credit the government is expanding funding to the Integrated Child Development Services (ICDS), the main programme tasked with malnutrition reduction among infants, but without governance reforms this could be a case of throwing good money after bad.” So what should be done? Haddad says, first, fund communities and local governments to undertake social audits of the ICDS actually delivered. Let the ultimate customers rate the provision and make the results public. This will put pressure on local MPs and local providers. Second, give the comptroller and auditor general a bigger role in monitoring government action on nutrition. Their work is already cited by many, and they should be empowered to do more. Third, simplify the ICDS. There are too many interventions and too many age-groups. It is complex to run, especially given the thousands of different contexts it has to adapt to. At the moment it tries to be all things to all people, and runs the risk of satisfying no one. Fourth, find an effective cross-ministry mechanism to deliver food, care and health in combinations that work. Efforts to lift the curse of malnutrition must be unified. Fifth, historically excluded groups must be involved in the design, outreach and delivery of nutrition programmes, reaching out to women from these groups in particular. Sixth, introduce simpler but more frequent monitoring of nutrition status so that civil society and the media can hold the government and non-state actors to account for year-on-year slippage, and reward them for progress. Finally, develop new ways of teaching and doing research on how to improve nutrition. Reducing malnutrition is not just about health, agriculture and economics. It is also about politics, governance and power. September’s National Nutrition Week is not enough; every day should be Nutrition Day if India is to escape the duality of being an economic powerhouse and a nutritional weakling. Source: Press Trust of India, September 18, 2009
The Hindu, September 16, 2009
http://in.reuters.com, September 2009
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