In India, child malnutrition has been improving gradually. Between the last two National Family Health Surveys (NFHSs) conducted in 2015-16 and 2019-21, children who are underweight reduced by 3.7 percentage points, those who are stunted reduced by 2.9 percentage points, and those who are wasted reduced by 1.7 percentage points, which is good progress.

However, disruptions due to two years of the Covid-19 pandemic and the recent macroeconomic situation would lead to an increase in malnutrition in coming years.

The rapid rise in food prices in the last few weeks was the proverbial last straw on the camel’s back. Rising food prices always hit poor households hard.

Many expenses like house rent, fuel, electricity, educational expenses, etc., cannot be reduced. Hence, families will buy less food and most often children will bear the brunt.

Currently, inflation is running at 7.8 per cent and food inflation, at 8.4 per cent. If food prices rise by 20 per cent, families may be able to afford 20 per cent less food if there is no scope for dipping into savings or to increase income. The burden of such a reduction in food purchases is more likely to fall on women and children.

Pandemic impact

The pandemic had hit the economy hard, especially the unorganised sectors. Sectors such as hotels, restaurants, tourism, handicrafts and many small and medium industrial units suffered.

Unemployment has also peaked recently and workforce participation has declined, indicating that people out of work are not looking for employment.

All these have led to reduced income in poor and lower non-fixed income households. When incomes reduce, it has a cascading impact on small businesses such as fruit and vegetable vendors, kirana shops, tailors, etc. So their incomes also drop.

On top of the pandemic came the Russia-Ukraine war and the disruptions of supplies of grain, oil, gas and many commodities that pushed global inflation to historic highs. If this storm was not enough, record breaking high temperatures in March and April in India led to a dip in wheat production. This along with global wheat shortage has led to price increase of wheat and other cereals.

Low incomes, combined with high inflation, will definitely upset the food budget of low-income families. One should remember that around 68 per cent of Indians live on under-$2 per day, and hence are on margins of poverty. This will lead to increasing rates of malnutrition in the country. It may reverse the gains of the last 30 years of improvement in the nutritional status. Unfortunately, there is not much discussion on this in the media.

The Centre and State governments as well as UN agencies like UNICEF, WHO, etc., have to immediately start working on ways to reduce the impact of this perfect storm on nutritional status of women and children.

Boost budgets

The budget for the ICDS (Integrated Child Development Services) and MDM (mid-day meal) schemes have to be increased to adjust for the rise in commodity and fuel prices. The PM Garib Kalyan Anna Yojana (PM-GKAY) may have to continue to give subsidised rations to the poor for a longer time and may need higher budgets.

The Finance Ministry and the NITI Aayog have to work on these issues to explore where the money will come from. Food and fuel prices may rise some more in the coming months. And if the monsoon, which is predicted to be normal, fails this year then it will worsen the nutritional situation of women and children.

Fortunately, a few days ago, the government cut fuel prices, a much-needed measure to cool the inflation. Many more steps have to be taken. One of the factors for food inflation is poor logistics, wastage, and such other inefficiencies. The government must work on these to make the agriculture logistics more efficient as well as try to reduce the margins of traders to reduce prices.

Along with this, the government must think of subsidised distribution of essential micronutrients (vitamins and minerals) to the poor. One tablet a day will not cost more than 25 paise per person.

Micronutrient deficiencies are not well documented in India, but going by whatever data is available, such deficiencies are found to be high in normal times and can be expected to rise in times of inflation and low incomes.

In such conditions the first things families will cut out is fruits and vegetables as they are relatively costlier than other food items (cereals), but they are the main sources of micronutrients.

In sum, if the nutritional safety nets such as ICDS, MDM and PMGKAY are not strengthened substantially now, India will see increasing malnutrition in the days to come, given this perfect local and global storm. We need to act now.

Mavalankar is Director, Rana is Associate Professor and Jani is Assistant Professor, Indian Institute of Public Health Gandhinagar (IIPHG)