PEOPLE & THEIR PROBLEMS

New Delhi, 18 January 2008

Child Malnutrition

INDIA LEADS IN INFANT MORTALITY

By Radhakrishna Rao

India, which has made impressive strides in area such as space exploration, information technology and stem cell research, is however, saddled with the problem of child malnutrition. Resulting in a poor track record of the country in human resources development.

In fact, a recent study by UNICEF highlights the fact that malnutrition among 35% of the children aged below 5 years and close to 9.4-million children outside the immunization network is the biggest challenge that India needs to overcome to achieve the millennium developmental goals.

Even as the under-5 mortality rate has shown a certain decrease, underweight births and neonatal mortality are some of the health issues that need to be tackled immediately, says a recent UNICEF study. The States with the highest number of underweight children are Madhya Pradesh, Jharkhand, and Bihar followed by Gujarat, Orissa, Chhattisgarh, Uttar Pradesh and Meghalaya.

Although, India has covered much ground in bringing down the child mortality rate, the average annual rate of reduction in under-5 mortality between 1990-2006 has been 2.6% which needs to be improved to 7.6% per year, in the next five years to realize the millennium developmental goal by 2015.

As it stands, of the 19-million infants in the developing world with low birth weight, 8.3-million are in India. One of the biggest killers of infants in India is water-borne diseases thanks to the consumption of unsafe water. Here again, the failure of the Government agencies to make available safe, potable water to the entire population in the country has contributed in a big way to infant mortality. Presently, around 27% of the population is forced to make use of unsafe water.

Making matters worse, the prevailing poverty rate in the rural areas of States such as Orissa and Bihar is much higher than in African countries like Malawi or Ghana. Not surprisingly then, a recent UNDP document laments the fact that India has miserably failed to translate its impressive economic growth into developmental indexes at the grassroots level. In similar vein, the World Bank’s Development Policy Review points out that the growth which took place post liberalization in the 1990s did not touch the poorest of the poor. Particularly, in the southern and western regions of the country.

“Some of India’s southern States may be in the midst of a technology boom, but one in every 11 children in the country die in the first 5 years for lack of low cost medical intervention”, says the UNDP’s Human Development Report. Shockingly, Karnataka known for its world class IT (Information Technology) and high-tech industrial enterprises, has 44% of its children below three years who are underweight and 37% who have stunted growth.” Poor children are more prone to anemia due to the lack of calcium and other essential nutrients. Not only are they under-weight but also end up contracting diseases like tuberculosis.

It is speculated that India’s low per capita income making for a low purchasing capacity of the masses is a major factor behind the prevailing child malnutrition rate in the country. Surprisingly however, a number of countries in the sub-Saharan region who have lower levels of per capita income compared to India report a lower rate of child malnutrition. Bluntly, the poor state of public health services is a major contributor to child malnutrition in India.

Further, also affecting the health and nutritional well being of the children is the limited reach of maternal health care services. Happily, Tamil Nadu has done an impressive job in drastically reducing the incidence of infant mortality and child malnutrition through well conceived schemes implemented with a high degree of commitment and accountability.

There is no gainsaying, that reducing child malnutrition requires enhancing the women’s health status and the promotion of gender equity. According to a development economist, A.K.Shivakumar, “India’s high levels of child malnutrition reflect the continuing neglect of health care services, the inadequate reach and efficacy of health and child care services and the failure of the strategies to reach the new born children and those under the age of three. These deficiencies need to be addressed immediately”.

Even the rate of pre-natal mortality is quite high in the country --- 49 for every 1000 pregnancies. Such mortality has been found to be high in young mothers and in first pregnancies. Moreover, it is highest for the rural, poor and illiterate mothers. No matter that the infant mortality rate has been brought down to 68 deaths per 1,000 births.

The third National Family and Health Survey has revealed that 46% of the children are malnourished. Though the infant mortality rate has reduced by the introduction of various schemes, but it continues to be much higher than in other developing countries. This is compounded by the fact that less than half of all Indian women receive care after child  birth and only 40% give birth in hospitals or public health care centres. Surveys also show that more than half of the children of less than 5 years of age in the country are anemic.

The most distressing ground reality responsible for infant and child malnutrition is the fact that one in every 5 Indians suffer from hunger or semi starvation. Indeed, India is a poignant case study of how food sufficiency at the aggregate level has not got translated into food security at the household level.

Scandalously, a staggeringly large number of under nourished — about 214 million people --- are chronically food insecure in the country. And this has resulted in about half of the children suffering the symptoms of malnourishment with serious consequences for their physical well being and mental poise. What is more, over 20% children have a low birth weight and there is a high prevalence of anemia and other micro-nutritional deficiencies in children under 5 years of age. ---INFA

(Copyright India News & Feature Alliance)