Over the past 15 years India’s economic growth rate has been unprecedented. The International Monetary Fund reports an average growth in real gross domestic product (GDP) of nearly 6% in the 1990s and of 8% in 2000-10. The economic growth has not, however, been associated with corresponding reductions in the rates of childhood undernutrition. The National Family Health Survey, which provides India’s most authoritative statistics on nutrition status, showed that 43% of children under 5 years old were underweight for age in 1998-9; by 2005-6 the percentage had only dropped to 40%. At that rate of progress India will not reach its millennium development goal target (to halve the proportion of underweight children by 2015) until 2043. By contrast, China has already met its goal and Brazil is expected to do so by 2015.
Undernutrition is responsible for 35% of deaths among children under 5 and 11% of the total global disease burden. It also reduces schooling attainment: an improvement in height for age z scores of 1 is a predictor of an extra half a year of schooling and substantially increases the likelihood of being poorer later in life since less schooling is a predictor of lower wages (46% in a longitudinal study from Guatemala) and lower lifetime incomes.
During 1981-2005 India’s poverty rate fell from 60% to 42%. This decline is similar to China’s more lauded poverty reduction (a fall from 40% to 29%) over the same period. Yet unlike China, India is not reducing undernutrition. Given the importance of childhood nutrition it is important to ask why high levels of undernutrition are so persistent in India.
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