Malnutrition a national shame

Describing malnutrition in the country as a national shame, Prime Minister Manmohan Singh on Tuesday said the government could not rely solely on the Integrated Child Development Scheme (ICDS) to deal with it.

"The problem of malnutrition is a matter of national shame. Despite impressive growth in our GDP, the level of under-nutrition in the country is unacceptably high," Dr. Singh said after releasing a report on fighting hunger and malnutrition here.

Pointing out that India had not succeeded in reducing the levels of malnutrition fast enough, he said, "Though the ICDS continues to be our most important tool to fight malnutrition, we can no longer rely solely on it."

The report "Hungama’’ says that 42 per cent of children under five are underweight and 59 per cent were stunted. Of the stunted children, about half are severely stunted and about half of all children are underweight or stunted by the time they are 2 years old. However, it also suggests that the prevalence of child underweight had decreased from 53 per cent to 42 per cent in the past seven years indicating a 20.3 per cent decrease with an annual average decline of 2. 9 per cent.

"We need to focus on districts where malnutrition levels are high and where conditions causing malnutrition prevail," Dr. Singh said adding that the Centre had already initiated a multi-sectoral programme in the indentified 200 high burden districts.

He said that policy makers and programme implementers need to clearly understand many linkages -- between education and health, sanitation and hygiene, drinking water and nutrition – and then shape their responses accordingly.

"This 20 per cent decline in malnourishment in the last seven years is better than the rate of decline reported in National Family Health Survey-III," he said. "However, what concerns me is that 42 per cent of our children are still underweight. This is an unacceptably high occurrence," he said.

The report, on the survey conducted by Naandi Foundation, has been made at the insistence of the Citizens' Alliance against Malnutrition. Among those present at the function to release the report at the Prime Minister's residence included filmmaker-turned-MP Shyam Benegal, actor Rahul Bose, singer Penaz Masani, MPs Jay Panda, Jyoti Mirdha, Madhu Yaski Goud, Shahnawaz Hussain, and Union Minister Sachin Pilot.

Conducted by Naandi Foundation across 112 rural districts, the survey found "positive change for child nutrition in India is happening, including in the 100 Focussed Districts." The 100 Focus Districts are located across six states -- Bihar, Jharkhand, Madhya Pradesh, Orissa, Rajasthan and Uttar Pradesh.

Noting that the prevalence of malnutrition is significantly higher among children from low-income families, the survey found that children from Muslim or SC/ST households generally have worse nutrition indicators.

Birth weight is an important risk-factor for child malnutrition, the report said. It added that the prevalence of underweight in children born with a weight below 2.5 kg is 50 per cent while that among children born with a weight above 2.5 kg is 34 per cent.

The survey found that awareness among mothers about nutrition is low. "92 per cent mothers had never heard the word malnutrition."

Highlighting the negligence towards girl children even in their early childhood, the report said the nutrition advantage girls have over boys in the first months of life seems to be reversed over time as they grow older.

According to the survey, mothers' education level also determines children's nutrition. "The prevalence of child underweight among mothers who cannot read is 45 per cent while that among mothers with 10 or more years of education is 27 per cent".

The survey found that giving colostrum to the newborn and exclusive breastfeeding for first 6 months of a child's life are not commonly practised. "51 per cent of the mothers did not give colostrum to the newborn soon after birth and 58 per cent mothers fed water to their infants before six months," the report said.

The survey also emphasised the need for providing better services through anganwadi centres.

While a total of 96 per cent of the villages have their own anganwadi centre, 61 per cent of these only operate in pucca buildings.

"The anganwadi services accessed by the largest proportion of mothers (86 per cent) is immunisation; 61 per cent of anganwadi centres had dried rations available and 50 per cent provided food on the day of survey; only 19 per cent of mothers reported that the anganwadi centre provides nutrition counselling to parents," it said.