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Under-nutrition - a challenge for India

The Challenge

Preventing under-nutrition has emerged as one of the most critical challenges to India’s development planners in recent times.  Mahatma Gandhi's statement, "For the hungry, God is bread," is relevant for vast sections of the Indian population even today.  Despite substantial improvement in health and well-being since the country's independence in 1947, under-nutrition remains a silent emergency in India, where almost half of all children under the age of three are underweight, 30 percent of newborns born with low birth weight, and 52 percent of women and 74 percent of children are anaemic. Other major nutritional deficiencies of public health importance in the country are Vitamin A deficiency and iodine deficiency.
 
Productivity losses to individuals are estimated at more than 10 percent of lifetime earnings, and gross domestic product (GDP) loss to malnutrition runs as high as 3 to 4 percent.

Under-nutrition is the underlying cause for about 50% of the 2.1 million Under-5 deaths in India each year. The prevalence of under nutrition is the highest in Madhya Pradesh (55%), Bihar (54%), Orissa (54%), Uttar Pradesh (52%) and  Rajasthan (51%), while Kerala (37%) and Tamil Nadu (27%) have lower rates.

General under-nutrition, characterized by under-weight among children is more prevalent amongst rural children, scheduled castes and tribes, and amongst children with illiterate mothers.  The contributing factors for under-nutrition are household food insecurity and intra-household food distribution, imbalanced diet, inadequate preventative and curative health services, and insufficient knowledge of proper care and infant feeding practices.

Malnutrition amongst women is one of the prime causes of low birth-weight babies and poor growth.  Low birth weight is a significant contributor to infant mortality. Moreover, low birth-weight babies who survive are likely to suffer growth retardation and illness throughout their childhood, adolescence and into adulthood, and growth-retarded adult women are likely to carry on the vicious cycle of malnutrition by giving birth to low birth-weight babies.

© Ruhani Kaur / UNICEF / 2006
Counselling of parents in caring for sick children and incalculating proper feeding habits will go a long way in addressing malnutrition in small children

Started by the Government of India in 1975, the Integrated Child Development Scheme (ICDS) has been instrumental in improving the health and wellbeing of new mothers and children under 6 by providing health and nutrition education, health services, supplementary food, and pre-school education.  The ICDS programme is one of the largest national development programmes in the world. It reaches more than 34 million children aged 0-6 years and 7 million pregnant and nursing mothers. The government of India intends to universalize ICDS in the near future.  Other programs impacting on under-nutrition include the National Mid-day Meal Scheme, the National Rural Health Mission, and the Public Distribution System (PDS).  The challenge for all these programmes and schemes is how to increase efficiency, impact and coverage.

In the area of Child Development and Nutrition, UNICEF assists the Government to further expand and enhance the quality of ICDS by improving the training of childcare workers, by developing innovative communication approaches with mothers; helping to improve monitoring and reporting systems; providing essential supplies and by developing effective community-based early childcare interventions.  UNICEF also supports iron folic acid and Vitamin A supplementation for adolescents and young children respectively.  Another priority is collaboration with government and others to increase the use of iodised salt.

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The costs of treating malnutrition

  • The costs to treat severely under-nourished children works out to US$ 22.6 per child, from admission to discharge, over and above the costs needed to run the existing child care infrastructure in the country.
  • This money is used for food, medicines and training of health workers; feeding demonstrations and mobility support to rural women and children.
  • In Shivpuri district of M.P. UNICEF contributes US$ 13.5 of the $ 22.6.  In the same district, UNICEF reached 494 severely malnourished children from January to April 2006.
  • In Guna district, UNICEF treated about 60 children per month between October 2005 and April 2006.

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