Wednesday, March 18, 2009
The New York Times reports that even after a decade of galloping economic growth, child malnutrition rates are worse in India than in many sub-Saharan African countries. Despite robust growth and good government intentions, 42.5% of India's children are underweight. In contrast, China sharply reduced child malnutrition and now just 7% of its children under 5 are underweight, a critical gauge of malnutrition. Malnutrition makes children more prone to illness, and stunts physical and intellectual growth for a lifetime.
Economists and public health experts say stubborn malnutrition rates point to a central failing in India's democracy of the poor. Amartya Sen, the Nobel prize-winning economist, lamented that hunger was not enough of a political priority here. India’s public expenditure on health remains low, and in some places, financing for child nutrition programs remains unspent.
Yet several democracies have all but eradicated hunger. And ignoring the needs of the poor altogether does spell political peril in India, helping to topple parties in the last elections. Others point to the efficiency of an authoritarian state like China. India’s sluggish and sometimes corrupt bureaucracy has only haltingly put in place relatively simple solutions — iodizing salt, for instance, or making sure all children are immunized against preventable diseases — to say nothing of its progress on the harder tasks, like changing what and how parents feed their children.
While India runs the largest child feeding program in the world, experts agree it is inadequately designed, and has made barely a dent in the ranks of sick children in the past 10 years. The $1.3 billion Integrated Child Development Services program, India’s primary effort to combat malnutrition, finances a network of soup kitchens in urban slums and villages. But most experts agree that providing adequate nutrition to pregnant women and children under 2 years old is crucial — and the Indian program has not honed in on them adequately. Nor has it succeeded in sufficiently changing child feeding and hygiene practices. Many women here remain in ill health and are ill fed; they are prone to giving birth to low-weight babies and tend not to be aware of how best to feed them.
In a memorandum prepared in February, the Ministry of Women and Child Development acknowledged that while the program had yielded some gains in the past 30 years, “its impact on physical growth and development has been rather slow.” The report recommended fortifying food with micronutrients and educating parents on how to better feed their babies.
A World Food Program report last month noted that India remains home to more than a fourth of the world’s hungry, 230 million people in all. The International Food Policy Research Institute, based in Washington,D.C. recently ranked India below two dozen sub-Saharan countries on its Global Hunger Index. Childhood anemia, a barometer of poor nutrition in a lactating mother’s breast milk, is three times higher in India than in China, according to a 2007 research paper from the institute.
The latest Global Hunger Index described hunger in Madhya Pradesh, a destitute state in central India, as “extremely alarming,” ranking the state somewhere between Chad and Ethiopia. It also found that “serious” rates of hunger persisted across Indian states that had posted enviable rates of economic growth in recent years, including Maharashtra and Gujarat. In the capital, New Delhi, which has the highest per-capita income in the country, 42.2% of children under 5 are stunted, or too short for their age, and 26% are underweight. A few blocks from the Indian Parliament, tiny, ill-fed children turn somersaults for spare change at traffic signals.