New insights into child nutrition require a radical expansion of child development services

Posted by Jean Dreze |

Updated: December 17, 2020, 8:50:03 a.m.

The stagnation in stunt rates is particularly alarming. Unlike weight, height is not affected by short-term factors, so this is not a temporary setback. Stunting in childhood is associated with serious impairments later in life, including poorer academic performance.

Aside from two or three countries like Niger and Yemen, India has the highest percentage of underweight children in the world: a full 36 percent according to the National Family Health Survey 2015-16 (NFHS-4). In other South Asian countries, including Bangladesh (22 percent) and Nepal (27 percent), the corresponding proportion is much lower. If we focus on child madness (small height) rather than low body weight, India’s rank improves a bit, but it is still one of the most malnourished countries in the company of a dozen other countries such as Ethiopia, Congo and Afghanistan. These startling facts, based on the World Bank’s world development indicators, are rarely discussed in Indian prolix democracy.

Early data from the National Family Health Survey 2019-20 (NFHS-5) published a few days ago by the Minister of Health reveals another alarming fact: indicators of child nutrition did not improve between 2015-16 and 2019-20. In seven out of ten major states for which data were published, the proportion of underweight children increased during this period. Stunt training increased in six of these ten states.

The proportion of malnourished children in these 10 states combined (approximately half of the Indian population) can be estimated with reasonable accuracy as the population-weighted average of the state numbers. This equates to 36 percent for stunting and 34 percent for underweight – in both cases the same as the corresponding weighted average for 2015-16, based on NFHS-4 data. This suggests that progress in child feeding in India, modest as it used to be, has stalled.

The stagnation in stunt rates is particularly alarming. Unlike weight, height is not affected by short-term factors, so this is not a temporary setback. Childhood stunting is associated with serious impairments later in life, including poorer academic performance.

Note that the NFHS-5 data relates to the situation just before the COVID-19 crisis. A year later, there is a possibility that children’s diets have deteriorated. Indeed, numerous household surveys point to severe food insecurity across India in 2020. In the latest Hunger Watch poll, two-thirds of respondents (adults from India’s poorest households) said they were eating less nutritious foods today than they were before the lockdown. a terrifying thought. It would be surprising if this didn’t have a negative impact on child growth.

For the most part, lunchtime meals in schools and Anganwadis have been discontinued since the closure until today. Many states have tried to reach an agreement to distribute cash or “take-home rations” instead of cooked meals, but these measures have been largely arbitrary and inadequate. Children have also suffered massive disruption to routine health services – including vaccination – during the lockdown, according to the official health management information system. Anganwadis have been closed for almost a year in most of the country. The ongoing closings of Anganwadis and schools may have had other less well-documented consequences, such as an increase in child labor and child abuse. In short, 2020 was a major disaster for Indian children.

All of this requires urgent action. The first step is to assess the child’s development both for himself and for the future of the country. The NDA government has a lot of responsibility in this regard. In its first annual budget for 2015-16, the midday meal and Integrated Child Development Services (ICDS) allocations were cut significantly – well beyond what could possibly be justified on the grounds that states receive a higher share of the tax pool. The cuts were partially reversed later in the year, but to date the central lunch budget (Rs 11,000) is lower than the 2014-15 budget (Rs 13,000). In reality, the central allocation for ICDS is also lower today than it was six years ago. Poshan Abhiyaan, the NDA government’s flagship child nutrition company, has a tiny budget of Rs 3,700.

For several years, the NDA government also ignored the right of pregnant women to maternity allowance – 6,000 rupees per child under the National Food Security Act 2013. When it finally introduced a system (Pradhan Mantri Matru Vandana Yojana) for this purpose in 2017, The Benefits were illegally restricted to one child per family and Rs 5,000 per child. In many states, NDA allies and staff have also been shown to have rejected or rejected the inclusion of eggs in lunch and take-away rations – one of the best things that can be done immediately to improve children’s diets.

The upcoming budget for 2021-22 is an opportunity to make up for some of these mistakes. Ad hoc measures are not enough, we need bold and lasting initiatives. Revitalizing and revising lunch meals in schools and anganwadis would be a good start. Eggs are asking to be included for national policy reasons (not only in lunchtime meals but also in take away rations for young children and pregnant women), with a fruit option or the like for vegetarians. Extending maternity rights to all births, not just the first living child, is a legal obligation on the NFSA, and the spirit of the law also requires that its amount be increased well above the outdated norm of Rs 6,000 per child.

The ICDS program also requires a shot in the arm. India has an invaluable network of 14 lakh anganwadis administered by local women. Most of these Anganwadi workers and helpers are capable women who can work miracles in a supportive setting. The southern states and a few other states such as Himachal Pradesh and even Odisha have extensively demonstrated the possibility of turning village-level Anganwadis into vibrant child development centers. There is no better way to reach out to the country’s young children.

These are just a few examples of possible initiatives. However, none of this is likely to happen without some introspection of political priorities. If India’s overwhelming goal is to become a $ 5 trillion economy within a few years, there is no need to pay attention to children. However, when it comes to development in the full sense of the word, the child’s development is paramount.

This article first appeared in the print edition on December 17, 2020 under the title “Give children weight”. The author is visiting professor in the Department of Economics at Ranchi University

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