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Future imperfect in India – hungrier and deeper in debt

Jun 04, 2018

Data from the National Family Health Survey conducted in 2016 shows that little has been achieved in tackling malnutrition. Besides, there has been a sharp increase in the indebtedness of household.

Data from the National Family Health Survey (NFHS-4 conducted between January and December 2016 with a whopping sample size of 601,509 households) throws light on some disturbing facts. It found 35.7 per cent of children below five years were underweight, 38.4 per cent are stunted and 21 per cent are wasted.

The data on wasting is worrying. It gives India the dubious distinction of being one of four countries in the world with 20 per cent, or a fifth, of its children being wasted - other countries in this club are Sri Lanka, Djibouti and South Sudan.

A closer look at the data on wasting betrays that India is not only failing its children, it is failing the ones most marginalised and therefore most in need of support. The country has seen a small reduction in the three indicators of child malnutrition – namely being underweight, stunted, and wasted. However, wasting among children has grown by one percentage point from 1990-1994, when it was at 20 per cent. Sri Lanka is perhaps the only other country which has seen an increase in wasting among children. The prevalence of wasting among Sri Lankan children under five years increased to 21.4 per cent from 13.3 per cent in 2006-2010.

Which raises the question: Are the families these chidren come from capable of tackling malnutrition on their own? Data suggests that this is an impossibility. Recent data on household indebtedness shows an increase in the number of families incapable of decreasing malnutrition. The All-India Debt and Investment Survey conducted by the National Sample Survey Office (NSSO) in its 70th round found about 31.4 per cent of rural households indebted in 2013 – up from 26.5 per cent in 2002. Corresponding figures for urban households are 22.4 per cent in 2013, up from 17.8 per cent in 2002.

Further demographic and regional analysis of the distribution of household indebtedness broadly follows the same trends as the distribution of malnutrition in the country. It exposes the reality that the more marginalised and underprivileged communities are, the more likely are they to be in debt, including debt from non-financial institutions.

The linkage between indebtedness and farmers’ suicides is also underscored by a recent study commissioned by the Reserve Bank of India and conducted by researchers at the Shiv Nadar University. The study is titled 'Lives in debt: narratives of agrarian distress and Farmer suicides'. The researchers conducting the study found that shame rising out of an inability to repay loans from kith and kin and friends is the single biggest reason behind rising farmers’ suicides. The study also listed faulty crop choices, rising input costs, and aspirational consumption patterns as other major factors driving suicides.

Further, figures from the 70th round of the NSSO, brings out the following. Although 52 per cent of the agricultural households in India are in debt with an outstanding loan average of Rs 47,000 per household, the situation is much worse in states like Andhra Pradesh, Telangana and Tamil Nadu. The percentage of indebted households in these states stands at a whopping 92.9 per cent, 89.1 per cent and 82.5 per cent respectively. The first two of these are also one of the worst hit by farmers’ suicides. This cannot be just a coincidence.

Is there any hope for improvement in the situation in the near future? Unlikely – government policy priorities reveal that child and maternal malnutrition are India’s most challenging health risks (in the Economic Survey of 2017-18). A comparision: The National Nutrition Mission (NNM) was launched amid much fanfare by Prime Minister Narendra Modi on International Women's Day this year with an allocation of Rs 9,046 crores (to be spent over three years). On the other hand, the Statue of Unity under construction in Gujarat has been allocated roughly a third of the budget (Rs 2,989 crores or aproximately US$460 million). The skewed priorities are apparent.

That the priorities are skewed also becomes apparent from the fact that NNM too comes 3½ years too late. In his budget speech in July 2014 (the present government's first budget), Finance Minister Arun Jaitley underscored the urgent need of “a national programme in Mission Mode” to address the “deteriorating malnutrition situation in India”. He noted that this was necessary as ‘present interventions are not adequate’. India required a “comprehensive strategy including detailed methodology, costing, time lines and monitorable targets.” He then proceeded to promise to put such a mechanism in place “within six months” – the National Nutrition Mission was only launched on March 8, 2018.

Even a cursory glance at the targets the government has set for the NNM makes it look farcical! The mission had set up a target to reduce under-nutrition and low birth weight by a mere 2 per cent each year. It will also strive to achieve reduction in stunting from 38.4 per cent as per the National Family Health Survey-4 to 25 per cent by 2022. That is an admission of India being okay with 25 per cent or one fourth of its children being chronically malnourished up to 2022!

The targeted reduction in anaemia-affecting more than 50 per cent of Indian women and children is even more absurd. The target, despite the fact that anemia and other nutritional deficiencies accounting for most of the neo-natal malnourishment cases is a mere 3 per cent reduction annually. This is when 33.6 per cent of Indian women are chronically undernourished and 55 per cent are anaemic. That is half of the women in the child-bearing age! This alone predisposes their children to malnutrition. How many decades does the Government need to tackle and resolve malnutrition?

Add to the situation that NNM is essentially an apex monitoring body with no executive rights and authority. Neither can it draw up a work plan by integrating inter-sectional interventions nor take any corrective measures even if it does identify problems. In sum, it will be yet another top heavy body with nothing much on the ground.

Fighting malnutrition in India requires a concentrated, coordinated and multi-sectional approach. It should be aimed at fighting agrarian distress, the issues of the urban poor and other marginalised communities by making them self-sufficient. It seems that this will not be happening anytime soon!

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