Richer states, poor performance, in reducing malnutrition
We normally assume that malnutrition is a disease of the poorer states, which the richer states are in the process of curing. It now transpires that malnutrition among women and child undernourishment, two essential markers of human development, are rampant in richer states as well.
States with high per capita incomes such as Gujarat and Haryana have performed poorly in transforming the growth they have experienced into the well-being of women and children. For instance, the fourth highest prevalence rate of underweighted children is in Gujarat (47.4%), according to a close scrutiny of the National Family Health Survey-III among children below 3 years. The state also has the third highest prevalence of the rate of stunted growth among children of the same age group. Haryana (35.9%) too has confronted a relatively higher prevalence of stunted growth among infants. In contrast, states like Kerala (21.1%), Manipur (24.7%), Punjab (27.0%) and Tripura (30%) have performed better in this arena.
But Kerala (28.8%), which has a better track record in terms of human development and which is certainly not a giant in the economic front as compared to Gujarat, also records lower prevalence of underweight babies. Some of the North Eastern states like Nagaland (21.7%), Mizoram (21.6%) and Manipur (23.8%) have performed better in reducing the menace of underweight child births, thanks to the higher literacy rates among females in these states. Punjab (27%) too has performed better than Haryana (41.9%) in this regard.
The NFHS-III survey conducted in 2005-06 shows that 80% of children in Gujarat aged below 3 years are anemic. Severe anemia among children is most prevalent in Rajasthan and Punjab. The percentage of women suffering from (any form of) anemia in some of the richer states like Haryana (56.1%), Gujarat (55.3%) and Maharastra (48.4%) comes closer to the national level figure i.e. 55.3%.
Rural poverty ratios in states like Gujarat (13.9%) and Haryana (9.2%) have not only been lower as compared to the national level (21.8%) poverty figure, they have also been lower as compared to the prevalence rates of undernourishment among children and women in these two states. This might serve as a blow to our policy makers who otherwise think that higher state domestic product (SDP) per capita coupled with lower poverty ratios might better the state of human welfare in terms of health and nutritional outcomes.
Plausible arguments behind poor nutritional status of women and children in richer states are: neglect of health-related infrastructure over the years, gender-based discrimination against women within the households that includes sex selection and female feticides, which is being practiced in states like Punjab and Haryana, lower status of women in the society, which is further perpetuated due to failures in policy implementation and rising cost of accessing health care.
The State of Food Insecurity in Rural India (2009) says that economically developed states like Gujarat, Maharashtra, Andhra Pradesh and Karnataka find themselves in the category of high food insecurity. In fact, one of the most prosperous states i.e. Maharastra has recently seen farmers committing suicides owing to agrarian crisis in its countryside.
The soon to be launched Right to Food Act, which is attempting to target the below poverty line (BPL) population must, therefore, widen its ambit so as to make the public distribution system (PDS) universal. It must also allow for continuing with existing food and supplementary nutrition schemes such as Mid Day Meal Scheme, (MDMS), Integrated Child Development Schemes (ICDS), Janani Suraksha Yojana (JSY) et al.
The links below contains information and debates surrounding the recent results of the NFHS-III.
Report on the State of Food Insecurity in Rural India (2009), United Nations World Food Programme (WFP) and MS Swaminathan Research Foundation (MSSRF),
National Family Health Survey-III, 2005-06, http://www.nfhsindia.org/
A New Institutional Economics Approach Towards Improving Social Sector Development in Orissa by S.S. Rath and Jyoti Vihar, Journal of Community Medicine, Vol. 4, No.1 January-June, 2008
Malnutrition rampant, may trigger crisis by Neeta Lal, India Together, 2 April, 2009,
Handbook of Statistics on Indian Economy, Reserve Bank of India,
Chapter 4: Nutrition and Social Safety Net, Vol II: Social Sector, 11th Five Year Plan,
Chapter 10: Nutrition and Anemia, IFPRI,
Female Infanticide and Feticide: The Declining Sex Ratio by Dr. Ranjana Kumari, Centre For Social Research, New Delhi, National Seminar on Violence Against the Girl Child, 10-11 February, 2006, Jaipur,