Now Reading
To Solve the Problem of Malnutrition, Its Many Dynamics Need to Be Understood

To Solve the Problem of Malnutrition, Its Many Dynamics Need to Be Understood

child malnutrition, food inflation, stunting, wasting, undernourishment, Union budget 2020, Integrated Child Development Scheme, midday meals, anganwadi, public distribution system, pulses, eggs, retail inflation, food prices, food basket, nutrient intake,

“…the State shall regard raising the level of nutrition and standard of living of its people and improvement in public health among its primary duties.”
∼ Article 47, Constitution of India

Over the last five decades, successive five-year plans have laid down policies and multi-sectoral strategies to combat nutrition-related public health problems. The right to freedom from hunger and malnutrition has been recognised and briefly discussed by the Supreme Court in several cases on the public distribution system filed by the People’s Union for Civil Liberties.

For dealing with such human rights violations, the National Human Rights Commission (NHRC) was set up through a statute in 1993.

The NHRC, on February 18, 2020, issued notice to the Uttar Pradesh government after taking cognisance of media reports on deaths due to malnutrition in several parts of the state. The commission saw this as a grave violation of the rights to livelihood, food and adequate medical care.

According to the World Health Organisation, ‘malnutrition’, in all its forms, includes under-nutrition (wasting, stunting, being underweight), inadequate vitamins or minerals, being overweight, obesity and resulting diet-related noncommunicable diseases. In other words, malnutrition refers to deficiencies, excesses or imbalances in a person’s intake of energy and/or nutrients.

The global burden of malnutrition is unacceptably high, with nearly half of all deaths in children under five years linked to poor nutrition. While the Indian government is aiming at a $5 trillion economy by 2024, the State of the World’s Children 2019 report by UNICEF has shown that malnutrition has caused 69% of child deaths below the age of five in India. Every second child in that age group is affected by some form of malnutrition.

The report further states that almost two in three children between six months and two years of age are not given food that supports their rapidly growing bodies and brains. This puts them at risk of poor brain development, weak learning, low immunity, increased infections and, in many cases, death.

On nutrition, India also ranked 102 among 117 countries on the Global Hunger Index (GHI) 2019. According to the Indian government’s own National Family Health Survey (NFHS) 2015-16, more than 35.7% of children under five years of age are underweight, over 38.4% are stunted, and more than half of all children are anaemic.

The undesirable impacts of malnutrition are significant in adults, too. For example, the body mass index (BMI) of a sizeable proportion of women (23%) and men (20%) in the age group 15-49 is found to be falling below the norm.

A mother feeds her malnourished child in the Nutritional Rehabilitation Centre of Sheopur district in the central Indian state of Madhya Pradesh April 6, 2010. Credit: REUTERS/Reinhard Krause
A mother feeds her malnourished child in the Nutritional Rehabilitation Centre of Sheopur district in the central Indian state of Madhya Pradesh April 6, 2010. Credit: REUTERS/Reinhard Krause

The situation in UP

According to the Census 2011, with a population of nearly 22 crore, Uttar Pradesh is the most populous state in India. According to the NITI Aayog Health Index Report of 2019, Uttar Pradesh was the worst performing state with regard to death caused due to malnutrition. NHFS 2015-16 states that BMI below normal is most evident in Bihar, Jharkhand, Madhya Pradesh and Uttar Pradesh.

Various government initiatives have been launched over the years seeking to improve nutritional status in the country. These include the Integrated Child Development Services (ICDS), the National Health Mission, the Janani Suraksha Yojana, the Matritva Sahyog Yojana, the Mid-Day Meal Scheme and the National Food Security Mission, among others. However, concerns regarding malnutrition have persisted despite improvements over the years.

In 2013, an effort was made to address the hunger-nutrition challenge through the National Food Security Act. The law aims to ensure greater access to an adequate quantity of quality food at affordable prices. But a 2015 survey by Swaraj Abhiyan, a political organisation, reveals unsatisfactory progress in its implementation. Data samples collected from Uttar Pradesh show that at places experiencing famine-like conditions, barely half of the poor families had eaten any pulses in the 30 days preceding the survey.

Compounding other economic and political factors that abet deaths due to malnutrition are social and cultural challenges that tend to defeat the very purpose of a nutrition programme. To begin with, India’s massive population comprises such diverse community groups, of whom over 200 million (16.6%) are classified as ‘scheduled castes’. A plan, for instance (named Hausla Poshan Yojana) to provide nutritious food to pregnant women and malnourished children in Uttar Pradesh failed to even take off because there were supposed women beneficiaries who refused to consume the food prepared by Anganwadi workers belonging to the scheduled caste community, who have been historically regarded as untouchables by the upper castes.

I think that such problems will continue unless greater efforts are made to strengthen the existing initiatives [such as the Public Distribution System (PDS), Mid-day Meal Scheme, Integrated Child Development Services (ICDS), Village and Child Development Centres]. So, the Uttar Pradesh state government has to wake up and pull up its socks to act against the increasing number of deaths due to malnutrition.

Sarvesh Kumar Shahi is an assistant professor of law at KIIT University, Bhubaneshwar.

Scroll To Top