Malnutrition in India: Causes and Implications

Malnutrition is the condition that results from eating a diet in which certain nutrients are lacking, in excess too high in intake, or in the wrong proportions. It is responsible for nearly 45 per cent of deaths in children under-five, and around 3.1 million deaths in children under five annually. UNICEF report on child malnutrition shows that India is home to 61 million stunted children under five and 38 per cent of all stunted children in the world.

Protein Calorie Malnutrition

It refers to a form of malnutrition where there is inadequate protein intake. It is considered as the primary nutritional problem and also the 1st National Nutritional Disorder. The term protein-energy malnutrition applies to a group of related disorders that include marasmus, kwashiorkor and intermediate states of marasmus-kwashiorkor. Protein calorie Malnutrition is due to “food gap” between the intake and requirement.

Status of Malnutrition in India

• The rural India has more cases of malnutrition among children less than 5 years of age as more cases of stunted, wasted and underweight children.
• High malnutrition of all types prevails in illiterate mothers and mother with less than 5 years education.
• The percentage of underweight girls under five years of age is higher than boys under five years of age, while in the cases of stunted growth and acute malnutrition, girls are in a better condition.
• Malnutrition among children is highest for underweight mothers.
• The prevalence of malnutrition varies across states, with Madhya Pradesh recording the highest rate and Kerala among the lowest.

HunGaMa Report Findings

Brazil’s Fome Zero Programme

Brazil has made significant leaps in overcoming hunger by providing food security to the citizens. Brazil’s Fome Zero or Zero Hunger programme was initiated by the government in 2003. Based on the pillars of conditional cash transfer, school meals and strengthening family agriculture, Fome Zero has able to

• reduce poverty,
• provide food security
• reduce hunger.

Brazil’s child mortality rate was reduced by 13 points and 20 million people came above the poverty line. Although India showed better economic growth than Brazil, Brazil surpassed it in reducing poverty and increasing food security for its citizen.

• The “HUNGaMA” report and the activities of the Citizen’s Alliance Against Malnutrition from 112 districts over nine States tells that 42 per cent of children are underweight and 58 per cent are stunted by the age of 24 months.

Causes of Malnutrition

• Illness and disease resulting from maternal and child under nutrition,
• Changing diets and patterns of physical activity
• Obesity and overweight
• Lack of breastfeeding practices
• Deficiencies of vitamins and minerals such as vitamin A, zinc, iron and calcium.

Challenges & Implications of Malnutrition

• Under nutrition reduces a nation’s economic advancement by at least eight per cent because of direct productivity losses, losses via poorer cognition and losses via reduced schooling.
• Lack of medical facilities and trained medical personnel
• Inadequate transport facility also caused a large number of infant deaths.
• Lack of protocols: Lack of standard protocols and less trained doctors on standard Emergency and Essential Maternal Obstetric and New-born Care lead to most of the infant’s deaths with lack of health facilities and quality of antenatal services.
• Lack of medicine: Lack of iron and folic acid supplies and Injection Iron Sucrose IV to control and treat severe anaemia among pregnant mothers are not in regular supplies at rural areas.

Schemes to address the Malnutrition Problem in India

• National Food Security Bill: The bill, if passed will play major role in eradicating malnutrition in the country and overcoming calorie deprivation.
• Mid-day Meal Scheme: This programme is conducted with part subsidies from the Government and partly with donations from individuals and corporate. The meals served with the nutritional norms given by the government of India and aims to eradicate malnutrition among children in India.
• National Rural Health Mission: The National Rural Health Mission of India mission was created for the years 2005–2012, and its goal is to improve the availability of and access to quality health care by people, especially for those residing in rural areas, the poor, women, and children with the sub goal to Reduce infant mortality rate (IMR) and maternal mortality ratio (MMR)
• One full meal under Integrated Child Development Scheme: It is mainly for children and for pregnant and lactating mothers. Started in the year 1975, ICDS has been instrumental in improving the health of mothers and children under age 6 by providing health and nutrition education, health services, supplementary food, and pre-school education.
• ICDS Systems Strengthening and Nutrition Improvement Project: To overcome the malnutrition problem in eight selected states, a World Bank aided ‘ICDS System Strengthening and Nutrition Improvement Project (ISSNIP)’ worth Rs 2,89,300 lakh has been approved and made effective from November 2012. It makes efforts to promote healthy pregnancy, timely and exclusive breastfeeding, infant and young child feeding practices, as well as improvements in personal hygiene with a particular focus on children under three.
• Community mobilisation scheme of Acute Malnutrition: This Scheme aims to prove that a holistic, decentralized, community-based approach to malnutrition eradication with better health outcomes, be more inclusive for children under 5 and will be more cost-effective in the long-run than centralized approaches, especially for rural, marginalized tribal communities.