Stepping out of the shadow of India’s malnutrition

An immediate universalisation of the PDS, distribution of quality food items and community kitchens are a few solutions

November 28, 2020 12:02 am | Updated 12:29 am IST

“School- er prarthana sabhar somoy hotat matha ghure pore jaoar ghotona hamesai ghotte dekhi amra. Beshirbhag khetrei ora mid-day - meal khete chaay naa, jiggesh korle bole pete byatha hochhe, Sir (There have been numerous instances during the prayer session in schools where we often observe students feeling sick and falling down out of dizziness. Most of the times they do not want to take mid-day meals and when asked, they complain of stomach ache).”

These words were echoed during a telephonic survey which we conducted in the Burdwan district of West Bengal in September 2020, with schoolteachers on the health conditions of students. Apart from our academic interest, the survey had been largely motivated by a report in the Bengali daily, Anandabazar Patrika , on February 10, 2020.

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In this report, a schoolteacher had highlighted how girl students, who took admission in Standard five were relatively shorter in height than the previous year’s batch of students. This, the teacher inferred, was largely integrated with malnutrition that is burgeoning not only in the State but also in rest of the country. In line with what repeatedly restated in our survey, she had reported children from impoverished households not being able to have the mid-day meal many a time because of stomach-related problems, which, according to her, was a result of the children skipping breakfast. If this is found to be the general trend across India, such anecdotal evidence can have larger consequences that can very well lead to different manifestations of malnutrition.

Global reports, measures

Two recent reports — the annual report on “The State of Food Security and Nutrition in the World 2020” by the Food and Agricultural Organization of the United Nations and the 2020 Hunger report, “Better Nutrition, Better Tomorrow” by the Bread for the World Institute  – document staggering facts about Indian food insecurity and malnutrition.

Using two globally recognised indicators, namely, the Prevalence of Undernourishment (PoU) and the Prevalence of Moderate or Severe Food Insecurity (PMSFI), these two reports indicate India to be one of the most food-insecure countries, with the highest rates of stunting and wasting among other South Asian countries. The PoU measures the percentage of people who are consuming insufficient calories than their required minimum dietary energy requirement, while the PMSFI identifies the percentage of people who live in households that are severely or moderately food insecure.

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The reduction in poverty has been substantial going by official estimates available till 2011-12. However, malnutrition has not declined as much as the decline has occurred in terms of poverty. On the contrary, the reduction is found to be much lower than in neighbouring China, Pakistan, Nepal and Bangladesh. Except China, these are countries which had somewhat similar levels of PoU in and around the year 2000. In terms of percentages, the PoU has declined 24.7% between 2001 and 2018 for India; other data are China (76.4%), Nepal (74%), Pakistan (42%), Afghanistan (37.4%) and Bangladesh (18.9%). It must be noted that the decline in China is way higher than that of India, even though it had started with lower levels of PoU in 2000.

In contrast, Afghanistan (47.8%) that started with a higher base than India (18.6%) had experienced higher rates of decline. Of note is the fact that, economically, while Afghanistan is relatively much poorer and has gone through several prolonged conflicts in last two decades, it has been more successful in reducing malnutrition than India. Further, Pakistan and Nepal which had almost similar (slightly higher to be precise) levels of PoU in the initial years, have also successfully reduced malnourishment at a rate that is much faster than India. Therefore, irrespective of the base level of PoU, most of these countries have done better than India on this dimension.

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These findings also get substantiated through Food Insecurity Experience Scale survey , which covers almost 90% of the world’s population. Because it is not allowed to be conducted in India, direct estimates are not available. Instead, three-year moving average figures are given separately for the whole of South Asia and South Asia, excluding India. A difference between these two would roughly give us a sense about the extent and broad direction of the prevalence of food insecurity here. Our estimates indicate that between 2014-16, about 29.1% of the total population was food insecure, which rose up to 32.9% in 2017-19. In terms of absolute number, about 375 million of the total population was moderately or severely food insecure in 2014, which went to about 450 million in 2019.

Crucial elements excluded

Despite the National Food Security Act – 2013 ensuring every citizen “access to adequate quantity of quality food at affordable prices”, two crucial elements that still got left out are the non-inclusion of nutritious food items such as pulses and exclusion of potential beneficiaries. Because of this, there is little to disagree that the current COVID-19 pandemic would make the situation worse in general, more so for vulnerable groups.

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In fact the recently initiated “Hunger Watch” by the Right to Food Campaign presents a very grim situation, with close to one out of every three respondents reporting low food consumption and massive compromise on food quality. Though States have temporarily expanded their coverage in the wake of the crisis, the problem of malnutrition is likely to deepen in the coming years with rising unemployment and the deep economic slump.

Hence, a major shift in policy has to encompass the immediate universalisation of the Public Distribution System which should definitely not be temporary in nature, along with the distribution of quality food items and innovative interventions such as the setting up of community kitchens among other things.

This year’s Nobel Peace Prize was awarded to the United Nations World Food Programme , which should bring some of the focus back on these pressing issues of undernourishment and hunger in India. The need of the hour remains the right utilisation and expansion of existing programmes to ensure that we arrest at least some part of this burgeoning malnutrition in the country.

Amartya Paul is Doctoral Scholar, Centre for Development Studies, Thiruvananthapuram, Kerala. Upasak Das is Presidential Fellow in Economics of Poverty Reduction, Global Development Institute, University of Manchester

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