The health, longevity and well-being of Indians has improved since Independence, and the high levels of economic growth over the past two-and-half-decades have made more funds available to spend on the social sector. Yet, the reality is that a third of the world’s stunted children under five — an estimated 46.6 million who have low height for age — live in India.
A quarter of the children display wasting (that is, low weight for height) as well. As the Global Nutrition Report 2018 points out, this finding masks the wide variation in stunting levels in different parts of the country. District-level data show high and very high levels of stunting mainly in central and northern India (more than 30% and 40%, respectively), but less than 20% in almost the entire south. This shows the important role played by political commitment, administrative efficiency, literacy and women’s empowerment in ensuring children’s health. Food and freedom go together, and the availability of one strongly influences access to the other; social institutions can work to improve nutrition and children’s welfare in free societies, and the absence of hunger enables people to develop their capabilities. Governments should acknowledge the linkages and commit themselves to improved nutritional policies. The national framework to improve nutrition already exists. The Anganwadi Services scheme, which incorporates the Integrated Child Development Services, caters to children up to age six, and to pregnant and lactating women. If it has not worked well in several States, it must be subjected to a rigorous review and targeted interventions for supplementary nutrition made.
Among the factors affecting the quantity and quality of nutrition are maternal education, age at marriage, antenatal care, children’s diet and household size. Now that mapping of malnutrition at the district level is available, as in the Global Nutrition Report, it is incumbent on State governments to address these determining factors.
A second issue is that of the quality of nutrition in packaged foods available to children. Going by the report, only 21% of these foods in India were rated as being healthy, based on overall energy, salt, sugar and saturated fat on the negative side, and vegetable, fruit, protein, fibre and calcium as positive factors. The fact that the global average of processed foods scored only 31% and a peak of 37% in New Zealand indicates that whole foods and cooked meals emerge superior.
India should invest more of its economic prosperity in its welfare system, without binding itself in restrictive budgetary formulations. The Economic Survey 2017-18 put social services spending at 6.6% of GDP, an insignificant rise after a marginal decline from the 6% band during the previous year to 5.8%. The latest report on stunting and wasting should convince the Centre that it needs to understand the problem better and work with the States to give India’s children a healthy future.