India’s paradox of fast economic growth across several years and chronic malnutrition in a significant section of the population is well known. It has vast numbers of stunted children whose nutritional status is so poor that infectious diseases increase the danger of death. About 34 per cent of girls aged 15 to 19 are stunted in the country, according to a major review of global undernutrition by The Lancet . These adolescents, part of the post-liberalisation generation, have benefited the least from economic growth. Without active intervention to improve their access to appropriate food, the young women are bound to face complications during pregnancy and many are certain to deliver stunted babies, continuing the distressing cycle. What these insights underscore is the need for the political class to make the struggle against malnutrition a national priority. It is evident that in the absence of scaled-up programmes to build the health of the child and the teenager, and to provide opportunities for education and skill-building, India cannot really reap the so-called demographic dividend of a large young population. Neither can it substantially reduce its shameful levels of maternal and child mortality, attributable in good measure to lack of nutrients in the diet.
A quarter of all maternal deaths occur due to anaemia, and 19 per cent due to calcium deficiency, both of which cause often-fatal complications at childbirth, as The Lancet data confirm. Although India has some intervention programmes in place to provide iron supplements to women, there is evidence to suggest that this has not been scaled up in rural areas. Supplemental nutrition efforts are also hampered by superstition and rumour about effects on unborn children. These are communication challenges that the National Rural Health Mission must pursue vigorously. The broader task would be to improve universal access to nutrients through a basket of commodities — including pulses, fruits and vegetables — that can be supplied through a variety of channels. Clearly, the Public Distribution System and community-run not-for-profit institutions would form the backbone of such an effort. What is often forgotten in the discussion is the importance of early childhood nutrition — crucially, the first 1,000 days — for life-long health. Given this causality, the UPA government should have come up with a Food Security law that provides universal access to nutritious food, and such legislation should have received wide support across the political spectrum. Regrettably, most politicians have failed to grasp the importance of this social investment. It is now for civil society to press the agenda.