Significance: Global Hunger Index released recently by International Food Policy Research Institute remarked that India is ranked 100th out of 119 countries, and has the third-highest score in all of Asia — only Afghanistan and Pakistan are ranked worse. It further stated that at 31.4, India’s 2017 GHI score is at the high end of the serious category, and is one of the main factors pushing South Asia to the category of worst performing region on the GHI this year, followed closely by Africa South of the Sahara.
Statistics of nutrition levels in India:
- As per the Global Nutrition Report, 2016 in India there is an overall decrease of hunger measured by undernutrition. But the troubling statistics lie in the fact that level of undernutrition remains unacceptably high in the country. India ranks 114th out of 132 countries in stunting among children aged less than five and 120th out of 130 countries in under-5 wasting.
- The scale and the gender dimension of nutrition in India show that while there is economic growth of nearly 10 percent annually, rates of child undernutrition remain very high. According to NFHS-3, 48 percent of children under the age of five, are stunted due to chronic undernutrition, with 70 percent being anaemic.
- The nutrition situation of children is largely due to the situation of women. NFHS-3 indicates that 36 percent of Indian women are chronically undernourished and 55 percent are anaemic. Recent data form Bihar and Madhya Pradesh shows that girls represent up to 68 per cent of the children admitted to programmes for the severely malnourished.
New Trends in nutrition problems: India is becoming a land where the trends of overnutrition and malnutrition happen simultaneously. Over-nutrition is emerging as an emergency in India. As per the recent findings of the National Family Health Survey-4 (2015-16), the Body Mass Index of 15.5% of urban women was found to be less than minimum whereas 31.3% of urban women were in the category of overweight or obese. Around 15% of urban men were underweight, while 26.3% belonged to the category of overweight and obese.
Possible reasons for this trend:
Apart from poverty, there seem to be three key differences between districts with high and low levels of child malnutrition: the status of women, the kind of diets fed to children, and access to toilets.
- Poverty: In India, about 25% of people live below poverty line. They remain deprived of the basic necessities and are subjected to exclusion errors from poverty assistance programmes. So, without access to food, they will remain under malnutrition.
- Gender Inequality: Women tend to be avoided or neglected in household and community level due to the patriarchal nature of society.One of the primary reasons for children being undernourished in the country is that often their mothers are undernourished. One in five women is underweight in India. Women who are themselves undernourished or have a pregnancy at an early age, are at a greater risk of delivering low birth-weight babies, who are nutritionally disadvantaged right at birth.
- Sanitation: The link between sanitation and undernutrition is even stronger. Districts with low levels of access to toilets have much higher rates of child undernourishment compared to districts with relatively high levels of access to toilets. In a densely populated country such as ours, the lack of sanitation contributes to the spread of infectious diseases.
- Dietary pattern: A vast majority of Indians eat cereal-based food, mainly wheat and rice. There is an insufficient intake of food such as milk, pulses, and fruits and vegetables, which are rich sources of micronutrients. Women and children are the most vulnerable to micronutrient deficiencies. This has adverse affects on their health. Deficiency of iron in women not only reduces physical work capacity and causes fatigue, but could lead to depression and post-partum maternal haemorrhage. In children, it impairs growth and cognitive development.
The reasons for new trends of overnutrition could be because of steady decline in the food basket diversity, especially of traditional grains such as bajra and millet, which have high nutritional value. Also, because of the high purchasing power of the community, they turn towards intake of energy-dense junk food and soft drinks. Globally improvement in socioeconomic conditions has been associated with an increase in energy intake, especially from fat and sugar. In India, until two decades ago, physical activity in work, domestic and transport domains were very high. Because of the high physical activity level in daily chores, a majority of the population were moderately active and they enjoyed the health benefits of a moderate physical activity without any discretionary physical activity. The last two decades witnessed a tremendous change in lifestyles.
- A shift in focus from household food security and freedom from hunger to nutrition security for the family and the individual. Eg: National Nutrition Mission, Food fortification programmes etc.
- Screening of all the persons from vulnerable groups and identification of those with various grades of undernutrition
and appropriate management. Eg: National Family Health Survey.
- Promotion of appropriate lifestyles and dietary intakes for the prevention and management of over-nutrition and obesity.
- convergence of related sectors to provide integrated comprehensive services to improve nutrition and health status. Eg: ICDS scheme.
Conclusion: India has entered the dual nutrition burden phase of nutrition transition. The country will have to work towards shortening the duration of the transition and minimizing the prevalence of both under and overnutrition and their adverse consequences. The Sustainable Development Goal-2 aims to end hunger, achieve food security and improved nutrition and promote sustainable agriculture is a priority area for India. To ensure food and nutrition security, there is a growing need for a multisectoral approach.