“Urgent need to increase spending on nutrition”
Commission A Health & Nutrition Survey, says Save the Children
Hyderabad: Save the Children’s Nutrition Barometer, a study of nutrition-specific commitments by 36 countries, finds India sharing space with two other countries at the bottom of the table (Refer to Figure 1), failing on both commitments and outcomes. The Barometer aims to provide a snapshot of national governments’ political, legal and financial commitments and progress in addressing child nutrition. It gauges these commitments that are measurable and comparable across a diverse group of 36 countries that together account for 90 per cent of the world’s stunted children.
The countries that performed best in the Barometer are Guatemala, Malawi and Peru. All three show strong commitment with strong nutrition outcomes relative to the other countries in the group. Democratic Republic of Congo, India and Yemen show the weakest performance with frail commitments and frail outcomes. In fact, India is the only other country other than the Democratic Republic of Congo and Yemen that fails on both political and legal, and financial commitments. Countries in South Asia such as Bangladesh, Pakistan and Nepal are among the
36 countries that are part of the report but they fare better than India in dealing with malnutrition (please see the table below).
Save the Children India’s CEO Thomas Chandy said, “We know the geographic areas and the social groups where malnutrition levels are the highest. We also know the reasons. The report is a pointer to the need to back political commitment with adequate resources and effective mechanisms. In India, states that have supported their policies and schemes with adequate resources and political will have done much better in dealing with malnutrition and child mortality and maternal mortality.”
India comes out frail on both commitments and outcomes. India’s spending on health is abysmally low, a mere 1.67% of the GDP in the 12th Plan.
The Nutrition Barometer builds on existing indices such as the Global Hunger Index produced by the International Food Policy Research Institute (IFPRI) and the Hunger Reduction Commitment Index (HRCI) released by the Institute of Development Studies. It analyses commitments made by the national government to fight undernutrition and attempts to understand how they move with children’s nutrition status.
The report recognises that there are many diverse factors determining nutrition outcomes. UNICEF’s conceptual framework on the causes of malnutrition indicates multi-sectoral intermediate, underlying and basic determinants spanning food, health and care practices. National level factors such as economic growth, social policy, health systems and governance play a big role in combating and addressing nutrition. Agriculture and food security play a big role as well. At the household level, income and education are just some of the key factors that affect children’s nutrition.
The outcomes for India have been measured using the National Family and Health Survey 3 (NFHS 3) from 2005-06 in the absence of more recent data on malnutrition being available in the country. “This itself is a big lacuna that the government needs to address immediately. We don’t have accurate data or enough surveys. Unless we track the efficacy of our schemes and policies on the ground there can be no course correction even if it isrequired. There is an urgent need to commission a comprehensive health and nutrition survey in the country,” said Shireen Vakil Miller, Director for Advocacy and Policy, Save the Children.
India is also likely to miss the Millennium Development Goal on child mortality. While under-five mortality declined from 107 in 1995 to 64 in 2009. At the present rate India will reach 54 against the target of 42 by 2015. Malnutrition is one of the biggest underlying causes of child mortality in India.
“The results are shocking and a wakeup call for the government of India to start spending more on health and nutrition” says Dr. P. Anjaiah, State Program Manager (AP, TN and Karnataka), Save The Children India. “There are about 8.8 lakhs children die of malnutrition in India and the lack of commitment in the government would mean increased no of children dying of malnutrition in the country.” warned Anjaiah.
State-wise percentage of underweight children is as follows (NFHS3)
Andhra Pradesh 3
Arunachal Pradesh 32.5
Himachal Pradesh 36.5
J & K
Madhya Pradesh 60