Following are some excerpts from the site <
http://www.cini.org.uk/child_malnutrition.html> making some unconventional
claims on child malnutrition in India.

*[I. The Status is just Appalling.]*

*An estimated forty per cent of the world’s severely malnourished children
under five live in India.*

This is a shameful stain on a country that, with China, will be one of the
great economic powerhouses of the coming century. India has made huge
strides in the past decades in warding off the spectre of famine. The Green
Revolution should have gone a long way to tackling child malnutrition,
Norman Borlaug’s creation of dwarf spring wheat strains in the 1960s meant
that India could feed itself at last. Better farming techniques and food
security policies have made mass starvation a thing of the past.

Yet the problem of child malnutrition remains critical, and the reasons it
deserves concerted attention are many. Besides the obvious moral obligation
to protect the weakest in society, the economic cost to India is – and will
be – staggering, and the global food crisis this year can only be
significantly worsening the problem1,2. Moreover, statistics from as
recently as 2006 may well underestimate the problem, as rampant food price
inflation takes its toll on many millions of Indian families.
...

   - 47 percent of India’s children below the age of three years are
   malnourished (underweight).3 The World Bank puts the number – probably
   conservatively – at 60 million.4 This is out of a global estimated total
   of 146 million.
   - 47 percent of Indian children under five are categorised as moderately
   or severely malnourished.5

   - South Asia has the highest rates – and by far the largest number – of
   malnourished children in the world.
   - The UN ranks India in the bottom quartile of countries by under-1
   infant mortality (the 53rd highest), and under-5 child mortality (78 deaths
   per 1000 live births).6 According to the 2008 CIA fact book, 32 babies
   out of every 1,000 born alive die before their first birthday.7
   - At least half of Indian infant deaths are related to malnutrition,
   often associated with infectious diseases.
   - Malnutrition impedes motor, sensory, cognitive and social development8,
   so malnourished children will be less likely to benefit from schooling, and
   will consequently have lower income as adults.
   - The most damaging effects of under-nutrition occur during pregnancy and
   the first two years of a child’s life.
   - These damages are irreversible, making
   dealing with malnutrition in the first two year crucially important.9
   - A close reading of available statistics shows the problem to be far
   from uniform.10


*[II. (Partial) Disconnect between Poverty and Malnourishment]*

*Myth: India’s low per-capita income is the major underlying cause.*
In fact, the correlation between per-capita income and child nutrition is a
tenuous one: 28 out of 37 Sub-Saharan African countries have lower
per-capita income than India, and – as said above – most have lower levels
of child malnutrition.12 Other countries too have both lower per-head wealth
and lower child malnutrition, Mongolia, Vietnam and Haiti being just three.
And within India itself, there is no discernible correlation. Manipur
reported a per capita income of Rs 8114 in 1998 and a malnutrition rate of
28 per cent.13 Gujurat, on the other hand, reported a per capita income of
Rs 16,251 and a rate of 45 per cent, according to the Women’s Feature
Service.14 The percentage of underweight children in Gujarat (one of India’s
richest states) increased from 45 per cent at the start of the decade to 47
per cent in 2006.15 Therefore, despite reporting and measurement differences
and political factors inherent in reporting levels, one thing is clear:
malnutrition is not predominantly caused by low income.
...
In fact, there is no obvious linkage between levels of child malnutrition
and income poverty. 26 per cent of India’s population lives below the
poverty line, yet 46 percent of children under three are malnourished. Most
Sub-Saharan countries report higher levels of income poverty than India even
though levels of child malnutrition in India are consistently higher. And
within India itself, in 1993-4 in Haryana, 35 per cent of children were
reportedly malnourished with 25 per cent of the population under the poverty
line.16 In Assam, 36 per cent of children were malnourished, yet a full 41
per cent lived in poverty. In other words, although the destitute poor have
higher rates of malnutrition than the rich, poverty itself is not a sole
cause. And the quantity of food required to adequately feed an infant is
affordable for practically all families – half a chapatti or half a banana
or a boiled potato or a bowl of dal.17

*[III. The Main Cause]*

Is the problem specific to India? No: In fact, it’s part of a wider regional
anomaly. Fifty per cent of children across South Asia suffer from
malnutrition. So is it therefore cultural in origin? In 1996, India’s
pre-eminent physician-nutritionist, Professor Ramalingaswami, along with
Drs. Jonsson and Rohde, wrote an article entitled “The Asian Enigma”. At the
time, there was insufficient prior research, and no clear consensus on the
underlying causes of malnutrition. After considering various theories –
including high rates of vegetarianism in South Asia – the researchers placed
the blame predominantly on the extremely low social status of women relative
to men in South Asia (compared, say, to Sub-Saharan Africa).21
....
The status of women is readily linked to child nutrition. A malnourished
mother will give birth to a baby of low birth weight – the single most
important predictor of child survival.22 Common practices such as allowing
all the males of the household to eat first goes some way to explaining the
83 per cent rate of iron deficiency anaemia among Indian women (compared to
40 per cent in Sub-Saharan Africa). This problem is compounded by the need
for pregnant women to be cared for, by ensuring proper nutritional diet and
reducing the burden of work during gestation. Child rearing is usually the
predominant responsibility of mothers. In other words, a pregnant mother who
has children already suffers an even greater risk of a malnourished child
after birth. And according to the International Food Policy Research
Institute, a woman’s control over resources within the household also
affects her children. Numerous studies have shown that income or assets
controlled by women are more likely to be spent on items that benefit
children and themselves, such as food, clothing and health care, than assets
controlled by men.24 Very revealing is the statistic provided by the NFHS-3
that malnutrition among Indian children below the age of three born to
illiterate mothers (55 per cent) is more than twice the level (26 per cent)
reported among mothers who have completed more than ten years of schooling.
As a mother’s education per se cannot conceivably affect the health of a
child, this number speaks a great deal: both child malnutrition and
education are strongly correlated with women’s social status.
...
The link between women’s status and child malnutrition took a long time to
be empirically established. The IFPRI has been running one of the most
significant modern studies on effective strategies to reduce malnutrition.
The IFPRI – along with the Department of International Health at Emory
University – sought to address the shortfall in empirical research with a
2003 study.25 The study brought together data from 36 developing countries,
spanning over 100,000 children under the age of three, and a similar number
of mothers.

The study identified three factors contributing to the nutritional gap
between Sub-Saharan Africa and India. The most important was women’s status,
followed by sanitation and urbanisation.26 No effective solution will be
complete without a real effort to address women’s low social status in –
particularly rural – India. This issue – so often framed in ‘rights’
discourse, is integral for health promotion, and human rights and health
advocacy groups would do well to recognise their overlapping objectives and
to work together.

Another clue lies in low birthweights. Birthweights below 2,500 grams have
been found to be very closely associated with poor growth – not only during
infancy but throughout childhood. Estimates for India reveal that 20 to 30
per cent of babies fall into this category. The underlying health and
nutritional status of the mother – also closely tied to social status – is
the main cause of low birthweight. According to NFHS-3, close to a third of
Indian women suffer from Chronic Energy Deficiency, and have a Body Mass
Index27 of less than 18.5.

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Peace Is Doable

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