UNDERNUTRITION
The CNNS (Comprehensive National Nutrition survey) report by the Ministry of Health and Family Welfare assumes salience, especially against two important factors.
- The Global Hunger Index, 2019 – India’s Rank 102/170 countries.
- India’s past performance – moderate decline in child stunting (impaired growth of child) but not child wasting (thinness in the child). The report reveals that child stunting and the condition of underweight declined from 10 % to 7% point from 2005 to 2016 and in wasting the decline is 1% point. So, these factors make CNNS report timely and important.
Now, the urgent requirement is to increase the rate of decline.
EDUCATED MOTHERS
It is true that if you educate a man you educate an individual but if you educate a WOMEN you educate an entire generation and this has been proved by this report also. Stunting among children less than 4 years came down from 46% to 19%. 27% points decline when maternal education went up from no schooling to 12 years of schooling. There is also a phenomenal decline in the number of underweight children. Women’s secondary education is capturing the cumulative effects on household wealth, women’s empowerment and knowledge and health-seeking behavior. It is next to impossible to transform the poorest households into rich ones so soon. However, enhancing the education of women in general, is certainly feasible.
POLICY GOALS
- Ending open defecation
- Enhancing access to safe water
- Sanitation facilities
However, ending open defecation alone will not lessen stunting remarkably. For instance- in India, the child mortality rate is lower in Muslims compared to Hindus which occurs due to the former’s better sanitation and hygiene practices. Unlike child mortality, child stunting levels remain almost the same between both.
WAY FORWARD
Another aspect that is yet to be firmly embedded in nutrition policy is DIETARY DIVERSITY. It is important to move the present focus from staple grain fundamentalism i.e. wheat and rice of Public Distribution System (PDS) to a more diversified food basket like millets. Evidence suggests that dietary diversity is indeed good for reducing iron deficiency — anemia which is also high among the lower class people in India. Rising obesity among privileged groups is a cause for concern and it is an emerging public health problem in India that demands equal attention.
DECLINE IN CHILD WASTING
The report on child wasting reveals an interesting, rather surprising, turnaround. The amount of the decline in wasting is larger than that of stunting: about 4% points within 22 months. This is indeed a remarkable achievement, especially against a measly decline in wasting in the last decade. It means that many states have achieved an unprecedented decline in wasting, reversing their past poor record within a short period.
Surprisingly, these states have not performed equally well in reducing stunting, even though wasting and stunting share many common causes. Is this ‘empirical reality’ rightly captured by the CNNS or do these estimates indicate some sort of anomaly in data?
An independent validation not only dispels any doubts regarding data quality but also helps in identifying the drivers of rapid reduction in child wasting in India.
