Hunger & Malnutrition

India is one of the world’s fastest growing economies and our government is running one of the largest anti-malnutrition programs. Though, as per the most recent available data, roughly 40% of children under five are stunted and 21% of children under five are severely wasted or undernourished.

Recent Developments

State of Hunger in India

  • According to FAO estimates in ‘The State of Food Security and Nutrition in the World, 2018” report, 195.9 million people are undernourished in India. By this measure 14.8% of the population is undernourished in India.
  • Also, 51.4% of women in reproductive age between 15 to 49 years are anaemic. Further according to the report 38.4% of the children aged under-five in India are stunted (too short for their age), while 21% suffer from wasting, meaning their weight is too low for their height.
  • Malnourished children have a higher risk of death from common childhood illnesses such as diarrhea, pneumonia, and malaria.

Global Hunger Index 2018

  • As per 2018 Global Hunger Index (GHI), India was ranked 103rd out of 119 qualifying countries. The Global Hunger Index 2018 report was prepared jointly by global NGOs namely, Concern Worldwide (Ireland) and Welthungerhilfe (Germany).
  • With a score of 31.1, India suffers from a level of hunger that is serious.
  • The index, was released on October 10, 2018, highlights the level of hunger and under-nutrition worldwide fell to 20.9, down from 29.2 in the year 2000.

‘Hunger’ in India

  • India is home to the largest undernourished population in the world
  • 14.9% of our population is undernourished
  • 195.9 million people go hungry everyday
  • 21.0% of children under 5 are underweight
  • 38.4% of children under 5 years of age are stunted
  • 1 in 4 children malnourished

State of Food Security and Nutrition in the World Report 2018 (India)

  • India’s efforts at improving access to food and good nutrition are led by the National Food Security Act. There are special nutritional schemes for women and children operated through the States.
  • In spite of such interventions, 14.5% of the population suffers from undernourishment, going by the UN’s assessment for 2014-16. At the national level, 53% of women are anaemic.
  • In India, cereal production recovered markedly after two consecutive bad seasons. Country level prevalence rates of stunting among children under-five years of age in India is 38.4%.
  • As with most developmental outcomes, stunting prevalence varies markedly between poor and rich households. The stunting rates for the poorest, middle and richest quintiles are 50, 38 and 30 respectively.
  • India is on course and registered good progress towards achieving the target on reducing overweight in children under-five years of age.

Global Nutrition Report 2018

  • 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), according to Global Nutrition Report 2018
  • 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. Out of the total 150.8 million stunted children in the world, India is home to 31 per cent of them, while half of all ‘wasted’ children across the globe are also in India.

Hunger & Malnutrition

SDGs

  • In the MDGs, hunger and nutrition were partially addressed in Goal 1. No longer are both these indicators a smaller part of the larger hunger goal.
  • The key expansion in the SDGs, however, has been to incorporate the root of the issues rather than simply aiming to eradicate the problem, with the inclusion of sustainable agriculture and enhancing food supply as part of the goal to combat hunger and malnutrition.

Sustainable Development Goals (SDGs)

Goal 2: Zero Hunger

  • By 2030, end hunger and ensure access by all people, in particular the poor and people in vulnerable situations, including infants, to safe, nutritious and sufficient food all year round.
  • By 2030, end all forms of malnutrition, including achieving, by 2025, the internationally agreed targets on stunting and wasting in children under 5 years of age, and address the nutritional needs of adolescent girls, pregnant and lactating women and older persons.

Government Initiatives to Improve Nutritional Health

National Nutrition Mission

National Nutrition Mission was launched on the International Women s Day i.e. March 8, 2018 in Jhunjhunu district of Rajasthan with a view to address malnutrition in the country in mission mode. The launch coincided with expansion of ‘Beti Bachao Beti Padhao’ initiative which highlights the importance of improving social status and education levels of women in addressing the burden of malnutrition. NNM seeks to deal with the problem of malnutrition in the country comprehensively and holistically.

Targets under the Mission

  1. Reduce Stunting from 38.4% (NFHS-4) to 25% by 2022.
  2. Reduce stunting, under-nutrition, anaemia and low birth weight by 2%, 2%, 3% and 2% per annum respectively.

Other Schemes & Programmes by the Government of India

The Ministry of Health and Family Welfare (MoHFW) under the umbrella of National Health Mission (NHM) has implemented following schemes and programmes which address the issue of malnutrition:

  • Promotion of Appropriate Infant and Young Child Feeding (IYCF) practices that include early initiation of breastfeeding and exclusive breastfeeding till 6 months of age through ASHA worker and healthcare provider at health facilities.
  • In order to promote and support breastfeeding, Government has implemented “MAA- Mothers’ Absolute Affection” programme to improve breastfeeding coverage and appropriate breastfeeding practices in the country. A greater emphasis is laid on capacity building of the health workers on lactation management at both community and facility levels and 360 degree IEC campaign to create awareness regarding breastfeeding.
  • Vitamin A Supplementation (VAS) for children till the age of 5 years.
  • ‘National Iron Plus Initiative’ has been launched as an effective strategy for supplementation and treatment of anaemia in children, adolescents, pregnant and lactating women, in programme mode through life cycle approach. Specific program to prevent and treat micronutrient deficiencies through Iron & Folic Acid (IFA) supplementation across life stages are:
    • Bi-weekly IFA syrup supplementation to children 6 – 59 months.
    • Weekly IFA tablet supplementation to children 5 – 10 years and adolescents 10 – 19 years
    • IFA tablets to pregnant and lactating women.
  • •National Deworming Day is a fixed day strategy to administer Albendazole tablets to all the children in the age group of 1-19 years through the platform of AWCs and Schools. More than 75 crores doses have been administered since 2014.
  • In order to increase awareness about the use of ORS and Zinc in diarrhoea, an Intensified Diarrhoea Control Fortnight (IDCF) is being observed during July-August, with the ultimate aim of ‘zero child deaths due to childhood diarrhoea’.
  • Incentives are provided to ASHA for tracking of Low birth weight babies.
  • Promotion for intake of iodised salt and monitoring salt quality through testing under National Iodine Deficiency Disorders Control Programme.
  • Mission Indradhanush: Launched on 25th December, 2014 with the objective to ensure high coverage of children with all vaccines in identified districts with the goal of reaching the unreached to achieve 90% full immunization coverage in India.
  • Rashtriya Bal Swasthya Karyakram (RBSK) provides child health screening for 30 common health conditions by expanding the reach of mobile health teams at block level and establishment of District Early Intervention Centres (DEICs) at the districts for early interventions services.
  • Village Health and Nutrition Days and Mother and Child Protection Card are joint initiatives of the Ministry of Health & Family welfare and the Ministry of Woman and Child Development for addressing the nutrition concerns in children, pregnant women and lactating mothers.
  • Village Health and Nutrition Days (VHNDs) are monthly days held at village level in Anganwadi centre to increase the awareness and bring about desired changes in the dietary practices including the promotion of breastfeeding.

NFHS-4

  • National Family Health Surveys conducted periodically assess the nutritional status of the population over a period of time which is an outcome of the impact of all the schemes of the Government intended to bring about improvement in the nutritional status.
  • The latest National Family Health Survey (NFHS-4), 2015-16 shows a decline in the prevalence of malnutrition in the country as compared to NFHS-3 data, which is an outcome of the various schemes implemented by the Government towards this goal.
  • The percentage of stunted children under 5 reduced from 48% in 2005-06 to 38.4% in 2015-16, there has been a rise in the percentage of children who are wasted from 19.8% to 21% during this period. A high increase in the incidence of wasting was noted in Punjab, Goa, Maharashtra, Karnataka, and Sikkim.
  • There was a reduction in the proportion of underweight due to improvement in stunting.
  • The prevalence of underweight children was found to be higher in rural areas (38%) than urban areas (29%).
  • Further, more than half of India’s children are anaemic (58%), indicating an inadequate amount of haemoglobin in the blood.This is caused by a nutritional deficiency of iron and other essential minerals, and vitamins in the body.

United Nations Children’s Fund (UNICEF) Initiative

  • The United Nations Children’s Fund (UNICEF) is launches a pilot project of supplying nutritious food for children in the State. With the help of government departments involved in child care, other stakeholders and NGOs, UNICEF launched a Community Based Management of Acute Malnutrition (CMAM) and supply Ready to Use Therapeutic Food (RUTF) in the State.
  • Where ‘Acute Malnutrition’ is one of the reasons for child deaths in the world, and some lakhs of children are dying due to malnutrition every year across the globe, and RUTF contains therapeutic milk, sugar, oil and peanuts, which contain high vitamins, minerals and nutritious supplements, and the product saved some thousands of children suffering from severe malnutrition.

Addressing Malnutrition

  • There are multiple — about half a dozen — schemes to address malnutrition. These include Public Distribution System, Midday Meal Scheme, Integrated Child Development Programme and so on.
  • These are implemented by as many ministries as there are schemes but there is little coordination. Programme implementation is tardy and not uniform across the country.
  • Indeed, access to ‘nutritious food’ and affordability ought to be a guiding factor for policymakers.

Food Fortification

  • The key vitamins and minerals used for food fortification include iron, iodine, zinc, vitamin A, vitamin D, folic acid (B9), thiamin (B1), riboflavin (B2), niacin (B3), pyridoxine (B6) and cobalamin (B12). Among those vitamins and minerals, vitamin A, iodine and iron deficiencies create the greatest burden on public health and rank high on priority.
  • Other micronutrient deficiencies, such as riboflavin, folic acid, vitamin C and calcium, are also widespread. These deficiencies increase the risk of diseases such as goitre, blindness, anaemia and cognitive disorders.
  • The government started a nationwide food fortification program by enriching sugar with vitamin A, as sugar is the most widely consumed staple food in the nation.

Related Content