The Millennium Development Goal, MDG adopted by the General Assembly of the United Nations lists eradication of extreme poverty and hunger on the top. The mandate of the UNGA is to eradicate poverty and hunger at least by half, alongwith 17 other goals including child mortality, maternal health, gender equality and empowerment of women, etc. by 2015. India is also a signatory to the Declaration.
Poverty and hunger is different from malnutrition. Poverty as defined by the world body is anyone living on less than a dollar a day and suffer from hunger is extremely poor and hungry. Malnutrition on the other hand is, even if a person gets enough to eat, but do not get proper amounts of micronutrients – vitamins and minerals – to meet daily nutritional requirement is malnourished.
Prime Minister Narendra Modi claimed, India is well on its way to achieve the target of Millennium Development Goal, MDG, for under-five mortality rate. Addressing a Summit in Jaipur, Rajasthan recently, he said India’s under-five mortality rate stood at 126 against the global rate of 90 in 1990. But this figure dropped to 49 against a global average of 46 by 2013. ‘India is likely to reach close to achieving the MDG target if the current trend of annual decline is sustained,’ Modi expressed optimism.
Unfortunately, there is no validated data available in India about the burden of malnutrition. It varies widely depending on the assessment methodology adopted. A number of agencies have done studies, but again there is no convergence on the actual burden. There are two full-fledged ministries – Ministry of Health and Family Welfare and Ministry of Women and Child Welfare, which are mandated to ensure overall welfare of children in the country, and both differ on the size of under-nourished.
According to the last published health index of India – National Health Profile 2013, infant mortality rate (under five) per 1000 child birth at the level of 2012 was 52 and overall infant mortality rate per 1000 live birth was 42, whereas the target set for 2015 was 42 and 28 respectively. But there is no data on malnutrition – either the government do not accept malnutrition as a national burden or it is not seized of the gravity of the situation.
Latest independent studies, however, show malnutrition among under-five children is a major health problem in India. This is validated by the fact that India has the highest underweight children in the world, nearly double that of Sub-Saharan Africa, considered to be perennially poverty-stricken.
India had nearly 89 million children in the age group 0-3 years, according to 2011 population census and 35.6 million among them were underweight.
A recent study by the federal Ministry of Women and Child Development – ‘Rapid Survey on Children 2013-14’ have the following data:
India had an estimated 52% underweight children in 1990, and the country was expected to bring down the proportion of underweight children below 3 years to 26% by 2015. The progress has been slower than estimated and declined only by 3% by 2005-06, according to National Family Health Survey.
According to a study by Dr. Swarup Kumar Sahu of Jawaharlal Nehru Institute of Postgraduate Medical Education and Research, Puducherry and others, published in Journal of Natural Science, Biology and Medicine in its Jan-June 2015 issue, ‘malnutrition problem in India is a concentrated phenomenon that is, a relatively small number of states, districts, and villages account for a large share of the malnutrition burden — only 5 states and 50% of villages account for about 80% of the malnutrition burden.’
WHO estimates severe malnutrition in India amongst children in the age bracket of 1 and three to be 15.6%, which is much above the current estimate of 4.2% based on the classification of Indian Academy of Paediatrics and 13.7% among children between the age group of 3 and 5 years. This is again higher than the current estimate of 2.9%.
The lowest rate of under-weight children were in three most developed states – Kerala, Goa and Punjab and the north-eastern states, where the educational level is very high.
The Global Nutrition Report 2015 and India Health Report vindicate the concerned raised in the article. The India Health Report prepared by Transform Nutrition Consortium shows that India meets only two of the eight targets set by World Health Organisation (WHO).
KEY FINDINGS OF INDIA HEALTH REPORT 2015
* 38 % of children have stunted growth
* 18.6 % children under three years have birth weight below under 2.5 kilograms.
* Malnutrition is still prevalent as only 50.5 % infants of 6 to 8 months receive solid, semi-solid and soft food
* 69.5 % children aged between 6 to 35 months suffer from anaemia.