Can India feed all its children?

Despite India’s powerhouse growth in recent decades the country still accounts for nearly a quarter of all children dying before their fifth birthday worldwide. This isn’t only because India has a high number of births. The under-five mortality rate is 61 per 1,000 live births, which is much higher than in Bangladesh and Nepal. The majority of these deaths in India and around the world are due to wholly preventable or treatable causes, such as diarrhoea, pneumonia and malnutrition, which is the underlying cause of a third of all child deaths.

Malnutrition blights the life of millions of India’s children. Almost half are chronically malnourished (or stunted) and more than 70% of women and children experience serious nutritional deficiencies such as anaemia. Chronic malnutrition can lead to a lifetime of consequences such as poorer performance in school and lower earnings. This has huge implications not only for individual well-being but also for the economy in terms of lower productivity and for the nation in poor social development.

There are important reasons why economic growth has not translated into better health and nutrition. Its benefits tend to accrue to a smaller segment of the population first, which means that millions of households remain in poverty, unable to afford nutritious diets. Others might suffer from poor nutrition knowledge and practices. Inequalities across wealth, gender and caste means that the poorest children are most at risk of malnutrition. In short, the economic growth has been far from inclusive, and, coupled with deep-seated inequalities, has failed to improve social outcomes.

Malnutrition, however, is not insurmountable. Countries such as Brazil and Peru have shown how government commitment can make a huge difference. The recent Nutrition Barometer report, by Save the Children and World Vision, shows the important role of political, legal and financial commitments from governments. The Barometer shows frail commitment and outcomes for India.

Public health spending – both as a percentage of government budget and in per capita terms – remains low for a middle-income country with huge needs.

Implementation of the primary programme addressing health and nutrition, the Integrated Child Development Services (ICDS), has been uneven across the country and it has been criticised for failing to reach very young children between 0 and two years, the crucial growth period.

Nutrition monitoring is particularly weak. The last population-based survey was done in 2005-2006 making it difficult to track recent movements in health and nutrition outcomes across the country. However, what we know from the last National Family Health Survey is that health and nutrition outcomes differ largely across the states. Southern states such as Kerala and Tamil Nadu are much better than the national average, but mortality and malnutrition rates in other states mirror that of low-income countries in Africa. So, while there are success stories in large parts of India, there are unacceptable levels of deprivation elsewhere.

There are recent indications that the government is stepping up efforts to fight malnutrition. These include an announcement to triple the resources for the reform of the ICDS. The government has also participated in high-level forums on tackling child survival and global hunger. While these are promising signs, it is essential that they are followed through with action and adequate resources to improve children’s health and nutrition.

The benefits of healthy and well-nourished children go well beyond their families and communities. Collectively, they can trigger a virtuous cycle of good health and nutrition, economic growth and social development. It is one way in which much needed social transformation in India could happen, ensuring fair and bright chances for future generations.

Author: Jasmine Whitbread is CEO of Save the Children International. She is attending the World Economic Forum on India 2012.

Image: People raise their hands to collect food at Alampur village, India REUTERS/Krishnendu Halder