Monday, September 23, 2013

Malnutrition is Widespread, Hunger is limited & hidden



 Co-authored with Prof Charan Singh, IIMB

Introduction

Malnutrition is a persistent problem in India, though it is often confused with hunger. According to Food and Agriculture Organisation (FAO), about 18 per cent of India’s population was undernourished in 2012. Undernourishment is the main cause of children’s death, and according to UNICEF, India houses one-third of stunted/wasted, termed malnourished, children of the world.

Food and Hunger

According to different rounds of NSSO, the proportion of households in rural areas, getting enough food every day of the year, increased from 94.5 percent in 1993-94 (NSS 50th round) to 99.0 percent in 2009-10 (66th round). The proportion of rural households, not getting enough food every day, for some months of the year, declined from 4.2 percent to only 0.9 percent while those not getting for all months of the year, declined from 0.9 percent to 0.2 percent. In the urban areas, where, to begin with, shortage was much less, similar story unfolded. Thus food availability has reached a large segment of the population and the gap between the rural and urban percentages has narrowed appreciably.
In the survey undertaken from July 2009 to June 2010, NSSO reported that percentage of households not perceiving themselves as getting adequate food throughout the year was 2.1 per cent or less in all major states except West Bengal (4.6 percent) and Odisha ((4.0 percent). In urban India, similar percentage was less than 1.3 percent except Madhya Pradesh (1.4 percent). There are a few states in which food inadequacy appears to reach a peak during some months, illustratively, Arunachal (January, February, November and December), Odisha (February), and West Bengal (February). Inadequacy of food is being addressed through the targeted public distribution system (TPDS) and a wide network of fair price shops (Table 1). Therefore, the incidence of food inadequacy has declined in major states like Odisha and West Bengal, as well as across the country from 2004-05 to 2009-10.

Calorie Deficiency

Some organization’s measure hunger in terms of average calorie deficiency relative to a global norm. This Calorie deficit (CD) is an average, which under the assumption that the calorie distribution is normal suggests that people at the lower end of the distribution may be consuming inadequate food. India’s calorie deficit is the highest among the BRICs, but this is not surprising given India’s per capita GDP is the lowest among the BRICs. The primary justification for the Indian PDS system was to ensure that all Indian’s get adequate cereals (calories).  It is widely accepted that the enormous leakages in the PDS need to be plugged and the administrative costs reduced so that higher proportion of the expenditure reaches the intended beneficiaries. 
A sharply focused effort needs to be made to identify the hungry and calorie deficient households, who may be living in remote/hilly areas, or families with dis-functional male heads (drugs, alcoholism), aged or with serious disabilities or female headed households.

Malnutrition: Wasting & Stunting

There is still another persistent but separate issue of ‘malnutrition’ which is the main cause of underweight children. For instance in Rajasthan, in 2004-05, there is no food inadequacy but substantial ‘malnutrition’ as measured by underweight children (Table 2). This could be due to poor sanitation represented by non-existence of sewerage systems, open sewers, toilet facility and access to piped water. A reduction in malnutrition can be achieved by a focused nutritional and public health policy, better drinking water facilities, better drainage and sewerage system, education and public campaign about nutrition, hygiene and disease precaution


Table 1: Government Measures to Address Inadequacy in Food

No. per 1000 of households getting inadequate food some months of the year
2004-05
No. per 1000 of households getting two square meals everyday only some months of the year
2009-10
Number of Fair price Shops – in ‘000 - As on June 30, 2011  
Off take of Rice and Wheat under TPDS
 (in lakh Tone) -
2012-2013
State
Rural
Urban
Rural
Urban

BPL
AAY
APL
Total
Andhra Pradesh
6
1
5
1
43.6
10.5
6.4
14.3
31.3
Assam
17
3
12
5
34.0
4.7
2.9
10.6
18.3
Bihar
20
8
11
5
44.4
14.4
10.1
1.8
26.3
Chhattisgarh
26
1
10
0
10.4
4.8
3.0
3.9
11.7
Jharkhand
6
0
2
1
14.3
5.9
3.7
.1
9.7
Karnataka
3
1
1
0
20.5
8.1
4.3
10.5
23.0
Kerala
22
17
5
4
14.5
4.0
2.5
8.2
14.7
Madhya Pradesh
15
4
4
14
20.8
19.6
8.1
7.7
35.5
Odisha
48
4
39
5
28.4
11.7
5.1
4.3
21.2
Punjab
8
2
4
0
0.5
1.0
.5
4.5
6.1
Uttar Pradesh
14
7
6
1
73.4
27.9
16.9
20.7
65.6
West Bengal
106
7
38
8
20.2
15.5
5.8
14.8
36.2
All India


9
3
505.9
179.6
100.1
168.9
448.7



Table 2: Hunger, Poverty and Malnutrition
States
Inadequate food % 2004-05
Poverty % of Population URP 2004-05
Malnutrition under 3 yrs underweight children % 2005-06
Public Health
% of Households using piped drinking water 2005-06
Public health% of households access to toilet facility 2005-06
AP
0.5
15.8
36.5
67.8
42.4
Assam
5.0
19.7
40.4
11.6
76.4
Bihar
2.7
41.4
58.4
4.2
25.2
Chhattisgarh
2.2
40.9
52.1
16.8
18.7
Jharkhand
0.6
40.3
59.2
11.3
22.6
Karnataka
0.2
25
41.1
57.4
46.5
Kerala
2.3
15
28.8
24.6
96
MP
1.6
38.3
60.3
25.0
27
Odisha
5.3
46.4
44
10.2
19.3
Punjab
0.7
8.4
27
54.6
70.8
Rajasthan
0.0
22.1
44
45.4
30.8
Uttar Pradesh
1.5
32.8
47.3
10.3
33.1
West Bengal
9
24.7
43.5
27.9
59.5
All-India
1.9
27.5
45.9
42.0
44.5



A version of this article appeared in the 23rd September, 2013 issue of the Mint (Live Mint) under the banner “Malnutrition not Hunger ails India:  http://www.livemint.com/Opinion/3qMKRqinXT0Dlkl39K5N3M/Malnutrition-not-hunger-ails-India.html