- Nobel laureate Amartya Sen has always maintained that “Hunger is quiet violence”, which appears more realistic year by year as India struggles to combat malnutrition. According to the Global Nutrition Report 2018, India is facing a major malnutrition crisis as it holds almost a third of world’s burden for stunting.
- The findings should be alarming for the policymakers because when India began the National Family Health Survey, its stunting and wasting among children were on a par with Thailand. Today, Thailand has all but overcome the problem while we have made slow and uneven progress, even after then President Pranab Mukherjee launched a nationwide mass communication campaign against malnutrition in November 2012, with actor Aamir Khan as its face.
India has highest number of stunted kids
- With 46.6 million children who are stunted, India tops the list of countries followed by Nigeria (13.9 million) and Pakistan (10.7 million), the Global Nutrition Report 2018 said.
- Stunting, or low height for age, is caused by long-term insufficient nutrient-intake and frequent infections.
- India also accounted for 25.5 million children who are wasted, followed by Nigeria (3.4 million) and Indonesia (3.3 million).
- Wasting, or low weight for height, is a strong predictor of mortality among children under five. It is usually the result of acute significant food shortage and/or disease.
India and Pakistan carry almost half of world’s stunted children
- “More than half of the world’s children impacted by wasting (26.9 million) live in South Asia. Of the three countries that are home to almost half (47.2 per cent) of all stunted children, two are in Asia, with India having 46.6 million (31 per cent) and Pakistan having 10.7 million,” the report said.
- Globally, 150.8 million children under five years are stunted and 50.5 million are wasted, the report said.
- Of the 141 countries analysed, 88 per cent (124 countries) experience more than one form of malnutrition, the report said.
India has more than a million overweight children
- India also figures among the set of countries that has more than a million overweight children. The other nations are China, Indonesia, India, Egypt, US, Brazil and Pakistan.
- In four countries, more than a fifth of all children are overweight — Ukraine, Albania, Libya and Montenegro.
- Of the 38.3 million children globally overweight, 5.4 million are in South Asia and 4.8 million are in East Asia.
- Prevalence of overweight children is the highest in upper-middle income countries and the lowest in low-income countries.
- In urban areas, there are 7.1 per cent overweight children on average, whereas in rural areas 6.2 per cent children are overweight. It is slightly more common among boys (6.9 per cent) than girls (6.1 per cent), the report highlighted.
Factors responsible for stunting– a study of its distribution
- The report referred to a study by the International Food Policy Research Institute (IFPRI) which used district-level aggregate data from the 2015-2016 National and Family Health Survey, covering 601,509 households in 604 districts in India, to understand the causes of the spatial variation.
- Researchers used mapping and descriptive analyses to understand spatial differences in distribution of stunting. The mapping showed that stunting varies greatly from district to district (12.4 per cent to 65.1 per cent), with 239 of 604 districts having stunting levels above 40 per cent.
The study found that factors such as women’s low BMI accounted for 19 per cent of the difference between the low versus high-burden districts. Other influential gender-related factors included:
- Maternal education (accounted for 12 per cent)
- Age at time of marriage (7 per cent)
- Antenatal care (6 per cent)
- Children’s diets (9 per cent)
- Assets (7 per cent)
- Open defecation (7 per cent)
- Household size (5 per cent)
This study reinforced the multi-sectoral nature of stunting by highlighting that differences between districts were explained by many factors associated with gender, education, economic status, health, hygiene, and other demographic factors.
“India’s national nutrition strategy which is focused on addressing district-specific factors draws on analyses such as these along with district specific nutrition profiles to enable diagnostic work and policy action to reduce inequalities and childhood stunting,” the report said.
Malnutrition is responsible for more ill-health than any other cause
- Corinna Hawkes, co-chair of the report and director of the Centre for Food Policy said, “The figures call for immediate action. Malnutrition is responsible for more ill-health than any other cause. The health consequences of being overweight and obese contribute to an estimated four million deaths globally.”
- “The uncomfortable question is not so much ‘why are things so bad’ but ‘why are things not better when we know so much more than before,” she said.
- As in previous years, the Global Nutrition Report 2018 finds again that the problem of malnutrition remains severe across all regions and none of the countries are on course to meet all nine global nutrition targets.