Image source: OpEd in The Hindu – For a malnutrition-free India - Photo: 2019

Stunting a Hurdle to Sustainable Development in India

By Sudha Ramachandran

BANGALORE (IDN) – India’s needs to redouble its efforts to reduce stunting among its children not only because this would improve their mental and physical development, learning capacity and life chances but also, to meet the 2022 deadline set by its National Nutrition Mission and enable the world to achieve the Sustainable Development Goals (SDGs) by 2030.

According to India’s National Family Health Service-3 and 4 (NFHS-3 and 4) figures, the proportion of its children under five years of age that are stunted declined from 48% in 2006 to 38% in 2016. While the decadal decline is significant, the reduction per year was just 1%.

Not only is this the slowest rate of decline among emerging economies but also, at this rate, 31.4% of India’s children will be stunted by the 2022 deadline. According to the Food and Nutrition Security Analysis, India, 2019, a report prepared by the UN World Food Programme in collaboration with India’s Ministry of Statistics and Program Implementation, India should reduce stunting by at least 2% annually to reach the National Nutrition Mission target of 25% by 2022.

Stunting (low height for age) is a manifestation of chronic under-nutrition and India is home to the largest number of stunted children in the world; around 46.6 million of its children are stunted. Therefore, its progress in dealing with stunting will have “critical impact” on whether or not the global community will be able to meet the 2030 deadline in achieving SDG 2, which aims at ending all forms of hunger and malnutrition, an official in India’s Ministry of Women and Child Development told IDN.

Stunting and other forms of under-nutrition are said to be responsible for nearly half of all child deaths globally. Associated with an underdeveloped brain, it results in diminished mental ability and learning capacity and poor performance in school. It puts the individual at risk of nutrition-related chronic diseases, such as diabetes, hypertension, and obesity.

Stunting has “lifelong consequences,” Shoba Suri, Senior Fellow with the New Delhi-based Observer Research Foundation’s Health Initiative said. It prevents a child from realizing her full potential in education and thus leaves her with “fewer professional opportunities” later in life. Stunting impacts an individual’s capacity to earn a living. Stunted children are estimated to earn 20% less as adults compared to healthy individuals.

Stunting has potential implications for India’s economic development as well, Suri said, citing a World Bank study, which found that “a 1% loss in adult height due to childhood stunting is associated with a 1.4% loss in economic productivity”.

By reducing stunting India will be able to “improve economic productivity,” the government official said. Its success in preventing stunting will determine whether the global community will be able to achieve SDG 8, which “aims not just at economic growth but growth that is inclusive by the 2030 deadline.” SDG 8 cannot be achieved, she said, so long as “millions of Indians are stunted and thus unable to access full and productive employment.”

It was to combat malnutrition to prevent related problems like stunting among children that the Indian government has put in place programs focusing on child nutrition. Foremost among these is the Integrated Child Development Service (ICDS) which was launched in 1975. This program is aimed at improving child nutrition and health by providing nutrition supplements, immunization, and health check-ups for children between 0-6 years of age.

However, the ICDS has failed to have the desired impact. “Poor implementation of the program, lack of monitoring, gaps in the coverage of beneficiaries and inadequate skills of community workers” are among the reasons for ICDS’ failure to reduce stunting and other malnutrition-related problems more effectively, Suri said.

Besides, most nutrition intervention programs in India focus on the post-birth period. But nutrition and health of the pregnant woman impacts the development of the fetus. It is therefore essential that nutrition programs target pregnant women too.

Importantly, while stunting is directly linked to nutrition, studies point to the role that other factors like hygiene, sanitation, gender empowerment, immunization, education, poverty alleviation and agricultural production play in preventing stunting nutrition. Thus, preventing stunting should not be the concern of just the Ministry of Women and Child Development. It requires multiple ministries and departments, including those responsible for tribal affairs, water and sanitation, rural development, etc to co-ordinate their actions to step up the pace of reducing stunting in the country, the government official said.

In 2017, the Indian government launched the Prime Minister’s Overarching Scheme for Holistic Nutrition (POSHAN) Abhiyaan. Targets were set to reduce stunting, under-nutrition and low birth weight by 2% each and anemia by 3% by 2022. It “seems promising” as it “calls for multi-ministerial convergence,” Suri said.

However, this promising program is being crippled by disinterest and non-implementation. The Ministry of Women and Child Development recently informed the Indian Parliament that several state governments have not utilized the funds allocated to them for implementation of Poshan Abhiyaan, While Bihar is said to have utilized just a quarter of the allocated funds, states like West Bengal and Odisha haven’t taken even the first steps towards implementing this program while Goa and Karnataka haven’t begun utilizing their funds for fighting malnutrition.

“None of the four most laggard states can afford to not implement the Poshan Abhiyaan” as they all have “serious levels of malnutrition.” Average malnutrition in nine of Karnataka’s 30 districts are said to be higher than the national average. The percentage of Karnataka’s underweight children is almost as high as the national average. In the circumstances, no excuse proffered by the state government to justify its lethargic approach to malnutrition is acceptable,” an editorial in Deccan Herald said.

According to Suri, programs working to improve nutrition among children should focus on the first 1000 days of a child’s life as this period “is a critical window of opportunity”. Besides, spreading awareness “about under-nutrition, breastfeeding and infant and upcomes in children,” she pointed out.

Importantly, government departments and agencies cannot by themselves wage the war against malnutrition and related problems. The private sector and civil society as well as schools need to pitch in by prioritizing nutritious eating. [IDN-InDepthNews – 07 August 2019]

Image source: OpEd in The Hindu – For a malnutrition-free India

IDN is flagship agency of the International Press Syndicate. –

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