13 November 2011

Why India Needs a National Nutrition Strategy

This article was just published in the British Medical Journal.

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.

(For more see the above link).


16 comments:

Jaideep Gupte said...

Thanks for this Lawrence, and an insightful piece in the BMJ -

Dreze and Sen recently wrote a hard hitting piece in Outlook which you might have already read (Putting Growth In Its Place) which outlined a similar sentiment: India's economic growth story coupled with its slipping ranking on various social/health indicators amongst its South Asian neighbours, and indeed compared with large parts of Africa.

There are two levels we need to be aware of I think: at one level there is an urgent need to recognise this general decline in health, nutrition and related service (sanitation, immunisation) indicators. At another level however, it is just as urgent to recognise the peaks or outliers – like Gorakhpur district (eastern UP) which for some reason has the highest maternal mortality rate in the country. While the peaks and general trends are related phenomenon, might there be enough cause to not expect generalised public health programs (like the Janani Suraksha Yojana for example) to also deliver in extreme cases? And of course, this question is a lot more complex in conflict affected/inaccessible zones where there this little or no base-line data to even begin contemplating targeted health and nutrition programs.

Jaideep

Lawrence Haddad said...

Jaideep, thanks.

Yes, I have just read the Draze and Sen piece which picks up on similar themes...

I quite agree that we need to look at the outliers... the new Transform Nutrition research programme that IDS is a member of will be doing just that...why do some ICDS centres do so much better than others? for example

Muhammad Amir said...
This comment has been removed by the author.
Lauren Hixson said...

I agree. A concerted effort can be made by teachers, parents and food companies. A low-budget, yet interactive form of teaching can be created to encourage children healthy eating. The parents of these children can be made health partners and should also be taught on proper food preparation and cooking. This is one of the best preventive measures of malnutrition.

Grace Johnson said...

According to smart tuition reviews monitoring what students are eating are really important cause it'll provide them what their body needs and will help their mind function properly and, if their faculties are operating well then that's the only time they could absorb every single thing the school is teaching to them.

Muhammad Amir said...

The National Family Health Survey, which provides http://www.trimnutrition.com/hcg/hcginjections.html India’s most authoritative statistics on nutrition status,

Alice Summers said...

Look how nutrition affects all aspects of their lives in India. Children are the number one victims of the lac of nutrition, and true, India does need a strategy to make the nutritional foods accessible to the young ones. With proper nutrition, they can reduce the death rate among children, help them grow stable for school - and from schooling, the process goes on until they get employed and make great contributions to India's success.

Piper Whitfeld said...

I agree that they need a national nutrition strategy as soon as possible so they can prevent the increasing number of deaths among malnourished children. I think that they can do it if they want to. They just need to focus more on this problem.

Ben Boone said...

Actually, India is not the only one who's finding ways to solve national nutrition problem, there are so many countries that deals with it too. I just wish Government can come up with a good national nutrition strategy.

Antonio Kevin said...

India had been making nutrition programs for many decades now, yet there were no significant improvements. Perhaps program evaluation on health should be carried on so that it could be amended for a more effective breakthrough on malnutrition.

Felix Adkins said...

They have to come up with a good strategy as soon as possible. As I have known there are so many people especially children suffering from malnutrition.

Edward Hughes said...

Perhaps the under nutrition issue that kept on surfacing would be because of the unequal distribution of supplies or misinformation on preparing nutritious food by parents.

Ewen Patton said...

For decades, the malnutrition have not improved in India. The nutrition program should be evaluated and modified accordingly so that the problem be addressed as soon as possible.

Tim Sandoval said...

Aside from India, there are so many countries where hidden hunger exists. We should all be aware of this matter.

Peony Goodchild said...

What this means is that people in India still dies of malnutrition. It's a pity that the national government could not address this immediately and provide for their own people.

Nancy Mack said...

It seems that india's problem is prioritizing. The country has taken pains to pursue a period of industrialization and poverty reduction, but in so doing, they brushed aside important health issues like sanitation and nutrition. That's a major factor here, in my opinion.