“Most of the seven billion people in this world suffer from malnutrition. Half do not have enough to eat and the rest of us eat too much.”- Earle Gray
A child going to bed hungry is nothing short of a crime against humanity. Malnutrition among children and adults is sadly a global phenomenon even in the 21st century. In this article, Jyotirmaya Yadav provides an insight into the grave issue of malnutrition in India.
As we all know, every living organism requires food to be alive on this planet. Food is very essential for one’s growth and development or in other words, it is responsible for the physical and mental development of an individual. Food is a basic requirement of every living organism for survival on earth.
Whatever food a man eats must contain some specific nutrients like proteins, carbohydrates, fats, minerals, vitamins, roughage, water in the right proportion and sufficient quantity for healthy growth and development.
It is said that a lack or an excess of anything is dangerous. Similarly, a lack or an excess of these nutrients in the diet of a person can result in disorders of nutrition, which may be called malnutrition disorders. These disorders lead to acute or chronic malnutrition (also called stunting).
II. Important Definitions
- The diet which contains all essential nutrients in sufficient quantity is known as a balanced diet.
- Malnutrition can be defined as the lack or excess of nutrition in the diet of a person. It can also be defined as the state in which a person becomes weak and sick due to inadequate and unbalanced diet.
III. Types of Malnutrition
There are three types of malnutrition:
- Under Nutrition
- Excessive Nutrition
- Deficiency Disease
It is the stage of malnutrition which occurs due to the availability of insufficient food for a long period of time. People who belong to extremely poor or low-income groups often suffer from slow starvation. And this is the main reason for under-nutrition.
It is the stage of malnutrition which occurs due to overeating or overfeeding for a long period of time. A very good example of this is obesity. We can see this disorder very easily in the middle and upper class of the society.
This type of malnutrition occurs due to the deficiency or lack of a specific nutrient in our diet. The examples of such deficiency disease are protein-energy malnutrition, mineral deficiency diseases and vitamin deficiency disease:
- Protein Energy Malnutrition (PEM) – When a diet does not contain enough amount of protein and energy, or when a low amount of protein and energy is present, it is called protein-energy malnutrition. It includes the deficiency of protein, fats and carbohydrates. Indian children are affected by this most important nutritional disorder between the age group of 1-3 years.
The most common symptoms of PEM are:
- Loss in height and weight
- Susceptibility to many diseases of respiratory and gastrointestinal systems
- Poor muscular development
- Vitamin Deficiency Disease– The diseases which occur due to the deficiency of vitamins in the diet are called Vitamin Deficiency diseases. Examples of vitamin deficiency disease are night blindness, exophthalmos, beriberi, etc., in which night blindness and exophthalmos are caused due to the deficiency of vitamin A and beriberi is caused due to the deficiency of vitamin B1.
- Mineral Deficiency Disease- These are the diseases which occur due to the deficiency of minerals like iron or iodine in the diet. Some examples of these diseases are anaemia, goitre and rickets.
IV. Reasons for Malnutrition
There are two main reasons for malnutrition:
- Unbalanced diet
- Wrong food habits
As we have discussed earlier, most people are unaware of a balanced diet and its composition. Moreover, they don’t know the importance of a balanced diet. Generally, people prefer eating unhealthy food instead of consuming a healthy diet.
Nowadays, the consumption of fast-food has also increased. For example, if a child wants to eat chips, samosas, Maggi, chow mein or pastries, their parents do not dissuade them. Parents themselves also eat junk food and allow their children to do so as well.
Children do not want to eat raw vegetables. They only like potato-based foods that increase their weight. Cold drinks, chocolate, coffee, etc. provide enough calories but do not provide nutrients. Therefore, parents need to improve their children’s eating habits. They should eat nutritious food.
In the past, boys and girls were treated differently. Therefore, a large number of girls were found to be suffering from malnutrition. However, this is not the case today.
V. Status of malnutrition in India
The Global Hunger Index is based on:
- The number of undernourished people in the community
- The number of children under the age of five suffering from malnutrition (lightweight according to their height)
- The average number of children under the age of five at risk (low height according to their age)
- Death rates among children under five years of age.
In the Global Hunger Index 2020, India ranked 94 among 107 countries.
Some other important facts:
- India is much behind her neighbouring countries Bangladesh, Pakistan and Nepal in the Global Hunger Index 2020.
- According to the estimation of the Food and Agriculture Organization, around 194.4 million people are undernourished in India.
- In 2020, the child mortality rate for India is 29.8 deaths per thousand live births, which has reduced by 3.48% as compared to 2019.
- According to WHO, 1.9 billion adults are overweight or obese while 462 million are underweight.
- About 1 in 10 babies are born with low birth weight, and in South Asia, 1 in 4, and about 45 per cent of deaths among children under five are associated with malnutrition. These deaths often occur in low-income and middle-income countries where childhood obesity rates rise exponentially.
- According to data provided by the Indian government, about 67% of the country’s population suffers from malnutrition.
- The reason for creating a hunger map is to ensure that the world achieves the “Zero Hunger by 2030” – one of the goals of the Sustainable Development Goals set by the United Nations.
VII. Preventive Measures
The Government of India has taken important steps to tackle malnutrition. The government has been taking significant steps against it from the beginning. There are many schemes launched by the government to tackle hunger and malnutrition like Integrated Child Development Services, National Nutrition Policy, Mid Day Meal Scheme, etc.
Apart from these schemes, the Indian parliament has taken a concrete step by making an Act in 2013 i.e., the National Food Security Act, 2013 (NFSA 2013). Through the National Food Security Act, 2013 (also known as Right to Food Act), the government mainly focuses on providing food grains with a subsidy to two-third of the total Indian population.
The Act also focuses on the nutritional support of women and children. In addition to the diet of pregnant women and nursing mothers during pregnancy and six months after the birth of the child, women will be entitled to a maternity benefit of not less than Rs. 6,000. 14-year-olds will be entitled to a healthy diet according to the prescribed standards of healthy eating.
The main characteristics of the National Food Security Act, 2013 are:
- Pregnant women and nursing mothers will have the right to food and maternity benefits of not less than Rs 6000. However, it is applicable only for the births of two children.
- Older women in the home who are 18 years or older will be the head of the family for the purpose of issuing share cards.
- All Antyodaya Anna Yojana (AAY) groups to receive 7 kg of subsidized food per person per month (i.e., 35 kg of foodgrain/family/month).
- Ordinary families will be entitled to at least 3 kg/person/month. 75% of the rural population and up to 50 per cent of the urban population will be covered by the bill. Of these, at least 46 per cent of the rural population and 28 per cent of the urban population will be selected as priority families. All others will be selected as ordinary families.
Child malnutrition is a major obstacle to the nation’s development. In our country about 60% of the children are malnourished. Therefore, it is very important to eliminate this problem completely. Some suggestions to prevent malnutrition:
- Caregivers should change their own eating style, as children learn their eating habits in their own homes.
- Mothers should breastfeed their babies long enough.
- Children should be tested regularly.
- Teachers should provide learners with information on how to prevent malnutrition.
- Everyone should eat healthy and well-cooked food in sufficient quantity.
VIII. Schemes launched by the Indian government related to malnutrition
There are several government schemes running to tackle hunger and malnutrition, such as:
Integrated Child Development Services (ICDS)
- The Integrated Child Development Services scheme was launched in 1975.
- The program provides specific interventions targeted towards at-risk groups including children under the age of 6 and women.
- It is done by the Department of Women and Children Development.
- It provides six services namely additional nutrition, pre-school education, nutrition and health education, immunizations, health screening and referral services.
National Nutrition Policy (NNP)
- It was launched in 1993.
- The National Nutrition Policy (NNP) was adopted under the auspices of the Department of Women and Child Development.
- The NNP strategy was a multi-sectoral strategy to end malnutrition and provide nutritious food for all.
Mid Day Meal (MDM) Scheme
- Launched in 1995 as a centralized program.
- It provides that every child under the age of six to fourteen who attends classes I to VIII who enrols and attends school will be provided with hot, free-cooked meals every day except during school holidays.
- The Mid Day Meal Scheme comes under the auspices of the HRD Ministry of Education and Literacy.
Antyodaya Anna Yojana (AAY)
- Launched by the government in 2000.
- The aim of the scheme was to provide subsidized food grains to one crore poorest of poor families.
- The program was expanded again in 2003 and about 50 lakh less than the poorest families were given food grains.
Indira Gandhi Matritva Sahyog Yojna (IGMSY)
- This scheme was launched in the year 2010.
- The program aims to contribute to a more conducive environment by providing financial benefits to improve the health and nutrition of pregnant and breastfeeding mothers.
- It is implemented by the Department of Women and Children Development.
National Health Mission (NHM)
- The National Health Mission (NHM) was launched by the Indian government in 2013.
- It also took over the National Rural Health Mission and the National Urban Health Mission.
- Used by the Department of Health and Family Welfare.
- Extended again in March 2018, to continue until March 2020.
- Key components of the program include strengthening the rural and urban health system of Reproductive Health, Reproductive-Neonatal-Infant and Adolescent Children (RMNCH + A), and Infectious and Non-Communicable Diseases.
In conclusion, poverty is the main cause of malnutrition in India. Poverty and malnutrition create a vicious cycle, in which both are complementary to each other.
All the data collected for this work revealed that the majority of children suffer from malnutrition due to their unhealthy eating and overeating habits. This problem can be weeded out if the guardians pay more attention to the eating habits of their children. Meetings between parents, teachers and paediatricians will be very helpful in resolving this issue. All these steps must be taken urgently because today’s generation is the future. Children are assets of the nation, not liabilities.
In a general survey, I found that:
- Only 5% of children in the 3-7 year age group prefer green vegetables.
- Around 3% of them like pulses.
- 2% like milk.
- 7% of them like seasonal fruits.
- A good strength i.e., around 65% of children like Maggi/chowmein.
- 52% of children like cold drinks.
In this survey, on the basis of activeness, it was found that 38% of children were lazy and rest 62% were found to be active. Also, in this survey, it was found that 30% of children have a low frequency of infection while 70% of them have a high frequency of infection.
 Government for the sustainable development a foundation for the future, Routledge Publisher, 2005