Via Malnutrition Deeply: India’s Stunted Progress on Child Health 71 Years After. Excerpt:
Despite nearly 71 years of independence, Indian children are still bound by malnutrition and poor health, a result of absolute poverty and an ineffective state. It is widely recognized that health issues from nutritional deficiencies in childhood can have a compounding effect in adult life. Inadequate healthcare can be debilitating to society at large from multiple vantage points: public participation, individual freedom and labor supply.
Healthier citizens are better able to participate in public life and public activities, can choose from a larger set of opportunities, and are more capable in their jobs. Simply put, healthier individuals are able to do more, be more and contribute more. A critical question stares us in the face at this juncture: What is the actual status of child health in India?
Dire Straits for Children
There are several indicators that reflect the long-term health and nutritional experience of an individual or population. One can check whether a child is stunted, underweight or wasted. Studies have linked stunting to lower cognitive development, among other unfavorable outcomes.
In addition, cognitive development is also impaired by anemia (low hemoglobin caused by iron deficiency). Wasting is a result of acute significant food shortage and/or disease and is a strong predictor of under-5 mortality. Figures reveal that over 16 percent of children in India are severely stunted, as many as 58 percent children are anemic, while close to 7 percent are severely wasted.
These poor outcomes are in part, borne of inadequate diets – less than 10 percent children (6–23 months) receive the minimum acceptable diet. Starvation deaths still occur, as sheer poverty and deprivation have precluded a large number of people from being able to feed themselves or their children restricting their future lives. Age-appropriate vaccination coverage also remains low at 27.4 percent, thereby compounding the magnitude of the health problem. The state of child health in India is grave. Successive governments have recognized this and put into action various programs to tackle the issue.
Vital, but Falling Short
The Poshan Abhiyaan (National Nutrition Mission), launched in March 2018, has been one such step and aims to address malnutrition through convergence across ministries, improved technology and better targeting. It is premature to know of its impact, yet, critical in the battle against malnutrition have been Anganwadi Centres (AWCs) under the longstanding Integrated Child Development Services (ICDS) program that began in 1975. As part of the program, children and lactating and pregnant mothers have been eligible for cooked meals, health check-ups, and immunization services.
Even today, AWCs do not cover all children who require these services: only 1 in 2 children received any service according to National Family Health Survey 4 data. A quarter of ICDS beneficiaries are malnourished, a number that has increased from 15 percent in 2015 to 25 percent in 2017, as per analysis by the Accountability Initiative. This shows that even as ICDS coverage is expanding to include those who need it most, malnutrition remains a problem among those that avail ICDS services.
