In December 2012, Columbia University professor Dr Arvind Panagariya created raged a controversy over the number the number of malnourished children in India. Indian children were underweight not because of poor nutrition, he argued, but due to genetic differences.
Dr Panagariya’s arguments pitched those who were in favour of revising the standards to measure malnourishment against those who said his argument was flawed and international standards were considerate of the Indian situation as well.
Dr Ishaprasad Bhagwat, health manager, Save the Children NGO, falls in the latter category. Dr Bhagwat tells Firstpost why the debate on malnourishment should move beyond numbers and why the country needs a nutrition program.
How serious is the problem of malnourishment in India?
It is quite serious. According to the latest National Family Health Survey-III done in 2005-06, at least 43 percent of children in India are underweight, 48 percent are stunted and 20 percent have low weight for height. Around 8.1 billion children suffer from sever acute malnutrition in India.
Even the best performing states such Kerala and North Eastern states have an undernourishment rate of 20- 22 percent. In Bihar and Jharkhand, 50 to 70 percent of all children are undernourished.
Is the government doing enough to tackle malnourishment?
We don’t have a nutrition program. Everyone blames the Integrated Child Development Scheme (ICDS). But that is designed only to provide supplementary food. In the early 1970s, nutritionists in India discovered that children in India were not having the required intake of calories. To fill this calorie gap, is one of the primary objectives of ICDS. We are still following the same old model. That is not sufficient.
Why is that model not applicable now?
There is a change in purchasing power parity. People are not as badly off as in the 1970s. Yet, studies have shown that consumption of food has gone down. There is also a change in the food items that people eat now.
Do you suggest expanding the scope of ICDS?
Continue with ICDS, but integrate other programs with that. There is a pattern in areas where undernourished children live: They have no access to safe water, sanitation and hygiene, which are all important for the success of any nutrition program. .
Access to good quality health services is absent. They resort to private informal doctors.
There are no agricultural linkages. We have a range of grains which are actually enriched but they don’t reach the most impoverished block.
Lastly, we should ensure that future mothers are trained and their nutrition status really enriched.
What about the contribution of welfare schemes such as the National Rural Health Mission (NRHM)?
The NHRM has been tasked to address severely addressed malnourished children. The draft guidelines titled ‘community management of acute malnourishment’ are ready. But there is a tussle between NHRM and Ministry of Women and Child Development as to whose territory it is.
What is you views on the controversy surrounding number of malnourished children in India?
Dr Panagariya has been trying to say that India does not have as many malnourished children. As per his calculation, the number of malnourished children is 40 to 41 percent and not 49 percent. The debate on this yardstick is not new and has been happening since independence. I believe we should not change the yardstick simply to show a better performance. Indian children are as good as children from any other sub continent. But we need to feed them properly and give them a good environment to grow in.
Is yardstick not important for policy formulation?
We already have international yardsticks which we should follow. Forming a new one is not necessary. The WHO standard is extensive as it takes samples of children from all over the globe including India. WHO also concluded that nutrition needs of children in the critical period, 0-5 years, are same across the globe.
Updated Date: Jun 10, 2013 11:18 AM