Hunger and malnutrition increased under Modi govt, fifth National Family Health Survey reveals
There is an urgent need for the govt to act to prevent additional stunting, wasting, and deaths among children
Hunger and malnutrition is the index by which one knows the real level of development, no matter what the government may claim. The result released for the first phase of the 5th round of National Family Health Survey (NFHS-5) with reference year 2019-20 shows the decline, especially when compared with NFHS-4 with the reference year 2015-16, the period coinciding with the Modi Raj in India. The country has the largest number of stunted children in the world. The substantial progress between NFHS-3 (2005-06) and NFHS-4 has been lost.
NFHS-5 was disrupted by the general lockdown of the country in March, and therefore the results are available for only 22 states and UTs. The survey has been resumed last month and the results for rest of the states and UTs will be available by mid-2021, but the reference year will remain the same as the first phase. It means we will not have the real-time data after the COVID-19 pandemic.
However, one of the estimates referred by the UNICEF tells us that over 6,000 children could die a day globally due to secondary impact of COVID-19 out of which 1600 will be Indian children.
With disruption of income flowing to the households due to policy experimentation of the government, the crisis has been worsening. The health, nutrition, immunization, education, mental health, and physical safety of our children have further been impacted due the pandemic. Everything was disrupted during lockdown. Anganwadis catering to children under 5 run under ICDS were closed. Mid-day mill were not available to school going children because schools were shut down. Without a great intervention and investment, the growth and development of these wasting, stunting, and malnourished children will be severely impacted.
The latest survey NFHS-5 phase I has revealed that child under-nutrition had been on the rise even before the pandemic. The trend is most likely to continue in the second phase of the survey, and if it happens, it would be the first increase in child stunting in the last two decades. More infants had received immunization in the reference year, but the lockdown had also disrupted the immunization.
There are three key indicators to measure child under-nutrition, which are stunting, wasting, and underweight. A stunted child has a lower than expected height for age, a wasting one has lower than expected weight for height, and the one who is underweight has lower than expected weight for age. The share of stunted, wasted and underweight children has grown in the majority of the states surveyed in the first phase.
A surprising element of the survey result is that the rate of stunting have risen even in comparatively rich states such as Kerala, Gujarat, Maharashtra, Goa, and Himachal Pradesh in the last five years, though they had lowered their rates of stunting between 2005-6 and 2015-16. It may be related to overall economic downturn that had increased even the level of unemployment at a 45-year high.
In 18 of 22 states and UTs surveyed, over a quarter of children under five were stunted. Minimum level of stunting was recorded in Sikkim which was 22.3 per cent, which is not a low level of stunting. It rose up to 46.5 per cent in Meghalaya, a percentage that speaks loudly about the highest level of neglect of children compared to any of the states and UTs in the country. Bihar followed Meghalaya with 42.9 per cent. Gujarat, Karnataka, Assam, Maharashtra, and Dadra & Nagar Haveli had stunting between 35 and 40 per cent.
In the range of 30-35 percent were West Bengal, Telangana, Nagaland, Tripura, Lakshdweep, Andhra Pradesh, Himachal Pradesh, and Ladakh. Stunting between 22 and 30 per cent were recorded in Mizoram, Jammu & Kashmir, Goa, Kerala, Manipur, Andaman & Nicobar, and Sikkim.
The percentage of wasting is less severe than stunting, but it is also unacceptably high for all the states and UTs surveyed. It ranges from around 9.8 per cent in Mizoram to 25.6 per cent in Maharashtra. Barring Mizoram, having wasting rate of 9.9 per cent, no state and UT has wasting rate less than 12.1 per cent (Meghalaya). Six states and UTs have over 20, and 18 have over 15 per cent of wasting children.
Children underweight presents more saddening picture, indicating that very large number of children were not even getting food. Underweight children in Bihar were highest at 41 per cent followed by Gujarat at 39.7, Dadra & Nagar Haveli at 38.7, and Maharashtra at 36.1 per cent. Except Mizoram (12.7), Sikkim (13.1), and Manipur (13.3), all the states have around 20 per cent and above number of underweight children. Ten states and UTs were in the range of having 25-35 per cent of underweight children.
How come children have not been getting sufficient food and nutrition? It was decidedly due to bad policy decisions, be it demonetization, unemployment, market oriented policies, or budgetary support. We can take example of even the last Union Budget that did not address the financial and resourced shortages affecting nutrition. Allocation to overall nutrition sensitive schemes fell by 19 per cent though several of them received marginal increases. Service delivery mechanisms have never got sufficient level of funding.
The most critical food subsidy scheme under the National Food Security Act was allocated 37 per cent less. It adversely impacted 67 per cent of population, 75 per cent in rural and 50 per cent in urban areas, whom the scheme was serving
There are at least 14 schemes sensitive to nutrition, most of which are getting insufficient funding. Financial burden on states has been on the increase due to several reasons, including curtailment of their right to collect taxes and non-payment of their share in time from the central revenue such as GST. Many of the central schemes are being run on cost sharing basis which most of the fund starved states were not able to meet. It all had impacted our children. Just in one year in 2018, an estimated 883,000 children under five died. Under the impact of Covid-19, additional deaths, stunting, wasting, and underweight are estimated to increase up to 50 per cent in the worst scenario and 10 per cent in the best, which must be addressed in the coming budget 2021-22.
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