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UPSC Editorial Analysis

Issues and Challenges associated with Undernutrition in India

[GS Paper 2 - Health and Education]

Context – Undernutrition is a serious public health issue leading to adverse health consequences and affecting the economy, especially in India. Early stimulation and nutrition interventions in infants and young children lead to improved outcomes in adult life.
India ranks poorly on the Human Capital Index and has high levels of stunting, anemia, and malnutrition. Evidence suggests investing in maternal and early-life nutrition leads to high returns on investment.

What is Undernutrition?

According to NCBI, Undernutrition denotes insufficient intake of energy and nutrients to meet an individual’s needs to maintain good health. In most literature, undernutrition is used synonymously with malnutrition. In the strictest sense, malnutrition denotes both undernutrition and overnutrition.

Reasons behind Undernutrition/Malnutrition in India

  • Monoculture agricultural practices: While foodgrain production has increased over five times since Independence, it has not sufficiently addressed the issue of malnutrition.
  • Changing food patterns: Food consumption patterns have changed substantially in India over the past few decades, which has resulted in the disappearance of many nutritious local foods, for example, millets.
  • Poverty: Though poverty alone does not lead to malnutrition, it affects the availability of adequate amounts of nutritious food for the most vulnerable populations. 
  • Lack of sanitation and clean drinking water: Lack of potable water, poor sanitation, and dangerous hygiene practices increase vulnerability to infectious and water-borne diseases, which are direct causes of acute malnutrition. 
  • Migration: Seasonal migrations have long been a livelihood strategy for the poorest households in India, as a means to access food and money through casual labor. However, children and women are the most affected, suffering from deprivation during migrations impacting their health condition. 
  • Gender injustice: There is a correlation between gender discrimination and poor nutrition. Malnourished girls become malnourished adolescents who marry early and have children who become malnourished, and so the cycle continues.
  • Lacunae at policy level: There is a lack of real-time data that brings all these factors together to show the extent of India’s malnutrition.

Effects of Undernutrition on Health and Economy

 

  • Child deaths: Undernutrition leads to 3.1 million child deaths annually, which accounts for 45 percent of all child deaths. 
  • High levels of stunting In India: India has unacceptably high levels of stunting (35.5 percent), despite marginal improvement over the years. 
  • Stunting affects per capita income: Two-thirds of India’s current workforce is stunted, which has enormous economic costs in terms of a decrease in per capita income. The average reduction in per capita income for developing countries is at 7 percent, with a high of 13 percent for India due to the high rates of stunting. 
  • Wasting in India: The economic losses incurred by India due to wasting are estimated at more than US $48 billion in terms of lifetime lost productivity. 
  • Anemia: Another compounding factor is anemia among young women, at 57 percent, which has lasting effects on their future pregnancies and childbirth. The situation further worsens when infants are fed inadequate diets, and there is inadequate sanitation and hygiene.

Measures to tackle Undernutrition

  • Investing in Well-being of Women and Children
  • Investing in early childhood: Evidence suggests that every additional dollar invested in quality early childhood programs yields a return of between US$6 and US$17.
  • Better income in future: Early stimulation in infants is known to increase their future earnings by 25 percent. Stunting in childhood leads to impaired brain development, lower cognitive skills and education, leading to lower incomes in the future.
  • For instance: According to estimates, children who are stunted earn 20 percent less as adults than children who are not stunted.

 

  • Investment in Human Capital
  • Human capital is the real wealth: The human capital is the wealth of nations and is dependent on the health, nutrition, skills, and knowledge of people.
  • Effective strategy: Evidence suggests investing in the well-being of women and children as an effective strategy for improved outcomes for children.
  • India’s ranking in Human capital Index: India ranks 116 out of 174 countries as per the Human Capital Index, with a score of 0.49 that indicates a child born in India will be 49 percent productive if provided with complete education and good health.
  • Education: Education to children plays a pivotal role in amassing human capital, improving productivity, and economic development. It has been advocated to target the 1000 days’ period from conception to two years of age for improving birth and nutrition outcomes.

 

  • Multi-Sectoral Approach
  • Substantial improvements across malnutrition indicators in the states of India would require an integrated nutrition policy.
  • These improvements include providing clean drinking water, reducing rates of open defecation, improving women’s status, enhancing agricultural productivity and food security, promoting nutrition-sensitive agriculture.
  • Integrated nutrition policy can be brought by harmonization of efforts across ministries, political will and good governance.
  • Such coordinated efforts will ensure that essential nutrition services reach the most deprived communities. 

Way Forward

Investing in healthcare facilities is crucial for enhancing productivity, economic growth, and security in India. Addressing undernutrition is necessary for producing and maintaining a healthy, highly skilled workforce in India.

Cost-effective investments in child health, nutrition, and education are necessary for improving public health and achieving economic growth in India.

Conclusion

Healthy human capital is the true wealth of any nation. In India, undernutrition is a significant public health concern that not only affects the well-being of women and children but also has adverse economic implications. Therefore, addressing undernutrition is critical for creating a healthy, skilled workforce, ensuring economic growth and security in India.

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