Malnutrition death in India

Despite decades of intervention, child malnutrition remains a shameful paradox in an India that aspires to occupy a larger global economic space. As a recent report in this newspaper revealed, “severe malnutrition” claimed the lives of over 450 children under the age of six in Madhya Pradesh since May 2008, reflecting the State government’s abdication of a basic duty. This is also symptomatic of a chronic social failing: the inability of governments to put deprivation issues at the centre of economic policy. Decades after planned economic development and targeted interventions, India has not achieved acceptable child nutrition levels: 38 per cent of its children aged under five are too short for their age (stunted), 15 per cent are wasted (too thin for their height), and a shocking 43 per cent are underweight, according to the World Health Organisation (WHO) data. The percentage of underweight children in other developing countries such as Brazil (four per cent) and China (six per cent) makes it clear that India has to go a long way before it could stake a realistic claim as one of the world’s emerging economic powerhouses. The country also risks the possibility of losing out on its advantage of “demographic dividend,” unless it makes urgent political and administrative interventions.

Action is required on two fronts. At a broader level, a nation’s nutritional well-being is directly linked to local food security. The frequent recurrence of the blight of malnutrition, despite an improvement in the food inadequacy status of households — the figure dropped from 4.2 per cent in 1993-94 to 1.9 per cent in 2004-05 — proves the continued validity of Nobel Laureate Amartya Sen’s proposition that food deprivation is the result more of distribution inequalities than the lack of food. Correcting this systemic inadequacy is the larger challenge; but improving the working of the Integrated Child Development Services (ICDS) is something the State governments can do if they had the political will and vision. The World Bank’s 2005 study on the working of the ICDS highlighted three important mismatches: the gap between design and implementation, the neglect of the poorest and the most vulnerable, and the poor quality of services. The National Family Health Survey-3 showed the States that had well-designed health intervention schemes such as immunisation programmes and maternal care fared better. There is much the State governments can do to prevent such shocking relapses into deprivation. Making local administrations accountable is a much-required first step to mainstream development issues into the political agenda.