Context:

This Article is based on the news “Nutritional crisis: India has most ‘zero-food’ children at 6.7 million; third highest prevalance among 92 LMICs” which was published in the DownToEarth. Recently, India has ranked poor in a study calculating the prevalence of Zero Food Children across 92 low- and middle-income countries (LMIC).

Study On Nutritional Security

• The research was published in the journal JAMA Network and looked at 276,379 babies aged six to 23 months in 92 LMICs.
• Data Collection Methods: The researchers gathered data from demographic and health surveys (DHS) and multiple indicator cluster (MICS) surveys.
• Period: May 20, 2010, to January 27, 2022. 
• India Specific Data: National Family Health Survey’s 2019-2021 data was used.

Nutritional Security in India: Key Findings of the Study

• Prevalence of Zero Food Children: India had the most ‘zero-food’ children at 6.7 million — almost half of all the zero food children in the surveys. 
  • With 19.3 percent ‘zero-food’ children, India was third highest globally after west African countries Guinea (21.8 per cent) and Mali (20.5 per cent). 
    • Nigeria had the second-highest number of zero-food children (962,000), followed by Pakistan (849,000).
• Regional Variations: The prevalence of zero-food instances differed by regions, with the highest rates seen in South Asia (15.7 per cent) and west and central Africa (10.5 per cent).

• Data on Breastfeeding: More than 99 per cent of the children who experienced zero-food situations had been breastfed.
• Zero Food Situation Variation Across Ages: 20 per cent of children aged 6 to 11 months had zero food, which decreased to 6.6 per cent for those aged 12 to 17 months and further to 4.1 per cent for those aged 18 to 23 months.

India-Specific Findings:

• Zero-Protein: More than 80% of children in the age group of 6-23 months had not consumed any protein-rich foods for an entire day (“zero-protein”).
  • According to NFHS-5 data ,close to 40% of children in the age group of 6-23 months did not eat any grains (roti, rice, etc.) for an entire day.
• Zero-Milk: Six out of 10 children in the age group of 6-23 months do not consume milk or dairy of any form every day (“zero-milk”).

Nutritional Security in India: Current Status

• Child Malnutrition in India:

• • Longstanding Child Malnutrition Challenge:The first National Family Health Survey (NFHS) in 1992-1993 revealed that over half of children under four were underweight and stunted, with one in six being excessively thin (wasted).
    • According to NFHS-5 data the zero-food prevalence was 30% for infants aged 6-11 months, 13% among 12-17 months old, and 8% among 18-23 months old.

• Global Malnutrition Ranking: 

  • The Global Hunger Index (2023) ranks India at 111 out of 125 countries.
    • India’s child wasting rate (low weight for height), at 19.3%, is worse than the levels recorded in 2014 (15.1%) and even 2000 (17.15%).It is the highest for any country in the world.

• Child Stunting: 

  • According to the fifth round of NFHS (2019-2021) data from 22 states, only nine showed a decline in the number of stunted children, 10 in wasted children, and six in underweight children.
    • 35% of children are Stunted and 57% of women and 25% of men are anemic.

Challenges Associated With Nutritional Security in India

• Cropping Pattern and Agriculture Practices: 

  • For instance, the cultivation of rice and wheat often overshadows the production of nutrient-rich crops like millets and pulses, contributing to nutritional insecurity.
    • For Example: At the end of fiscal year 2022, India had over 46 million hectares of land area for cultivation of rice, whereas area under cultivation of millets in 2021-22 is 15.48 million hectares

• Insufficient Funding: 

  • Many nutrition programs suffer from budget constraints, affecting their scale and effectiveness. India’s public health expenditure is still only about 1.3% of its GDP.

• Regional Disparities: 

• • For example, states like Punjab and Haryana have better access to nutritious food due to better facilities developed during the Green Revolution, while states like Jharkhand and Chhattisgarh face higher rates of malnutrition due to limited resources.

• Environmental Enteropathy: 

  • Poor hygiene and sanitation lead to a sub-clinical condition called “environmental enteropathy” in children, which causes nutritional malabsorption and is the source of a variety of problems, including diarrhoea, retarded growth and stunting.
    • For Example: prevalence of waterborne diseases and malnutrition as seen in several states, including Uttar Pradesh and Bihar.

• Social Factors: 

  • Low status of women in Indian society, Poor childcare practices, such as not immediately starting breastfeeding after birth and child marriages. 
    • Estimates suggest that each year, at least 1.5 million girls under 18 get married in India, which makes it home to the largest number of child brides in the world. 
    • Infants born to child brides in India (married before the age of 18) have a higher risk of malnutrition

• Food Wastage: 

• • Around 67 million tonnes of food is wasted in India every year which has been valued at around Rs 92,000 crores. 
    • For context, this amount is enough to feed all of Bihar for a year. Annually, nearly 21 million metric tonnes of wheat rots in India. This figure is equal to Australia’s total annual production.

• Politics of Distribution: 

  • According to Amartya Sen, hunger usually arises from food distribution problems, or from governmental policies in the developing world, and not from the insufficiency of food production. Corruption, leakages, exclusion-inclusion error etc. makes PDS inefficient.

• Climate Change and Natural Disasters: 

• • Frequent droughts, floods, and other climate-related events lead to food shortages. 
    • For Example: States like Maharashtra and Kerala have experienced adverse effects of climate change, affecting crop yields.

• Lack of Diversity Under Public Distribution System (PDS): 

  • The Public Distribution System (PDS) lacks more nutritious foods such as coarse grains, pulses, etc.
    • India’s protein consumption falls far below the recommended daily intake of 48 grams per day suggested by the Indian Council of Medical Research (ICMR). 
    • The recommended dietary allowance of protein for an average Indian adult is 0.8 to 1 gm per kg body weight.

• Cultural Practice: 

• • For example, a study in rural Rajasthan found that women eat last and consume lower quantities of nutrient-rich foods compared to other family members, resulting in compromised nutritional security.

Way Forward to Improve Nutritional Security in India

• Improving Agricultural Productivity: 

  • By ensuring scientific usage of water by means of drip irrigation and precision farming, cultivate a healthy environment with mixed crops, crop rotation, and bio fertilizers and using modern techniques like poly houses, green houses, shade houses and others.

• Universal Maternity Entitlements and Child Care Services: 

  • Enabling exclusive breastfeeding, appropriate infant and young child feeding as well as towards recognising women’s unpaid work burdens.

• Strengthening Public Systems: 

  • Enhancing the efficiency of the Public Distribution System, ICDS, and healthcare services is paramount. 
    • For Example: The computerization of PDS in Chhattisgarh exemplifies how technology can curb corruption and improve service delivery.

• Increased Budgetary allocations: 

  • Adequate  budgetary allocation can help to tackle the issue of nutritional security. Research suggests that $1 spent on nutritional interventions in India could generate $34.1 to $38.6 in public economic returns, three times more than the global average. 

• Nutrition Education and Awareness: 

  • Public awareness campaigns can educate people about the importance of a balanced diet, hygiene practices, and breastfeeding, etc.  
    • Example: My plate for the day to prevent hidden hunger is a nutrition awareness poster released by National Institute of Nutrition, Hyderabad. 
    • Other awareness campaigns include Eat Right Campaign, Right To Food, etc.

• Strengthen Inter-Departmental Convergence: 

  • In this regard, approach undertaken by Bangladesh can be replicated in India. 
    • For Example: The National Plan of Action for Nutrition of Bangladesh is based on a multi-sectoral convergence strategy involving health, education, fisheries and livestock, environment, social protection, disaster management etc to combat child malnutrition.

• Learn from International Experience: 

• • Thailand has been one of the most outstanding success stories of reducing child malnutrition in the period 1980-1988 during which child malnutrition (underweight) rate was effectively reduced from 50 percent to 25 percent.
    • This was achieved through a mix of interventions including intensive growth monitoring and nutrition education, strong supplementary feeding provision, high rates of coverage ensured, Iron and Vitamin supplementation and salt iodization along with primary health care.