Emaciated generation

Early data from the National Family Health Survey (NFHS-5) reflect an unfortunate rise in children malnutrition and stunting over the last decade. The NFHS is a nationally representative survey of 400,000 households on vaccination, health status, nutritional status which is yet to be completed in larger States such as Uttar Pradesh, Tamil Nadu, Madhya Pradesh. However, of the 22 States and UTs for which the data are available for 2019-20, malnutrition among children below five years of age has worsened in as many as 16 States/UTs, compared to 2015-16. Of the six States which have fared better, Kerala and Karnataka are the only big States, the rest being UTs and Meghalaya. The picture appears disturbing in the context of economic crisis, high unemployment and high income and asset inequality.

The 16 States which have regressed fare poorly on all the three key indicators used to measure child under-nutrition — stunting which is a lower-than-expected height for age, wasting which is lower-than-expected weight for height and underweight which is lower-than-expected weight for age. What’s most worrying is that the so-called richer States rank at the top of the list when it comes to the malnutrition indicators. For instance, in Maharashtra, an overwhelming 68.9 per cent of the children under five are anaemic, an increase of 15.1 percentage points over 53.8 per cent in 2015-16. The number of children stunted in Maharashtra shows an increase — from 34.4 per cent in 2015-16 to 35.2 per cent in 2019-20. The number of children who are wasted remains the same at 25.6 per cent and the number of underweight children shows an increase at 36.1 per cent as compared with 36 per cent in 2015-16. The data are unflattering even for States such as Karnataka (where anaemia has risen but the number of stunting, wasting and underweight children has fallen) and Gujarat, which are at the forefront of economic development. It is obvious that there is something very wrong with the policies and programmes aimed at boosting child health and nutrition. There seems to be a greater focus on increasing calorific intake of children to prevent hunger without adequate attention to the constituents of the food that they eat.

No country except Niger in Sub-Saharan Africa has a similar proportion of under-nourished children. The mismatch between our economic potential and the dissipation of human capital must be addressed with higher allocations towards mother and child care programmes, taking a leaf out of the successes achieved in States such as Tamil Nadu. Apart from higher allocations, it is important to learn from implementation errors of existing schemes. It is possible that a focus on the nutritional needs of schoolgoing children has led to a neglect of pre-school children. Mother and child nutrition should become a flagship initiative.