| Despite
rapid economic growth, the nutritional status of our
population appears to be worsening according to some
important indicators. This is what seems to be emerging
from major national-level surveys conducted by official
organisation such as the 61st Round of the national
Sample Survey, conducted in 2004-05, and the third National
Family Health Survey conducted in 2005-06.
Remember that these years are part of
a period of economic boom, the period when the Indian
economy (and therefore presumably Indians) have never
had it so good. Aggregate GDP growth rates have been
around 8 per cent on average and per capita GDP has
increased by around 6 per cent per year. In this ''take-off
phase'' it would be normal to expect that calorie consumption
and nutritional indicators would show some improvements,
even if not dramatic improvements, at least substantial.
But the data from the National Sample Survey Rounds
on consumption expenditure tells us that per capita
calorie consumption, far from rising, has actually decreased,
even for the poorest groups. Per capita foodgrain consumption
declined from 476 grams per day in 1990 to only 418
grams per day in 2001, and even aggregate calorific
consumption per capita declined from just over 2200
calories per day in 1987-88 to around 2150 in 1999-2000.
The latest NSS survey suggests further declines in calorie
consumption.
This cannot be entirely a sign of people moving towards
different (and qualitatively better) consumption patterns
through different food choices, as some analysts have
argued. Instead, it is more likely to reflect shifts
in wage incomes, relative prices and increasing costs
of health and other essentials, that have reduced the
ability of households to spend more on food.
The worst aspect is that this is happening in a context
of already very poor standards of nutrition on average.
The NFHS-3 provides some depressing reminders of the
low and in some cases worsening nutrition status of
most of our citizens, especially the young.
Take the proportion of children below 3 years of age
who are underweight. This indicator shows very little
improvement, especially when compared to the 1996-97
survey, and the proportion of underweight children remains
appallingly high at 46 per cent for the country as a
whole.
It is predictably higher in the more economically backward
states, such as Madhya Pradesh with 60 per cent, Bihar
with 58 per cent, Jharkhand with 59 per cent and Chhattisgarh
with 52 per cent. What is worth noting is that in several
of these states, the proportion of children actually
increased between 1996-97 and 2005-06! In Bihar it went
up from 54 to 58 per cent; in Jharkhand the increase
was from 54 to 59 per cent.
However, such a degeneration was not confined to the
poorer and more backward states, from where we have
got inured to hearing bad news. It happened also in
some of the more prosperous states. Thus, in Gujarat,
which is one of the richest states and has shown one
of the highest rates of economic growth over this period,
the proportion of underweight children also increased
slightly even between 1997-98 and 2005-06, from 45 to
47 per cent.
The statistics on anaemia are even worse. Not only are
the data on the prevalence of anaemia alarmingly high,
but they have actually got significantly worse since
the mid 1990s. In the latest NFHS survey, nearly 4 put
of 5 children in the age group 6 to 35 months had anaemia,
while nearly 3 out of every five ever-married women
and pregnant women also were anaemic. The prevalence
of severe anaemia also remains high.
Data on anaemia provide some evidence of the quality
of nutrition, and therefore address the point that some
analysts try to make about calorie consumption or even
weight for age/height not being correct indicators.
If even anaemia is on the increase in the country as
a whole, especially among vulnerable categories such
as children and pregnant women, we must have serious
concerns about the inadequate nutrition we are providing
our citizens.
There is an evident gender gap in operation here as
well: for adults, while anaemia is high among both sexes,
it is very high among women, with the prevalence of
anaemia among women more than double that among men
in almost all states. Once again, the states with the
highest levels of anaemia among the population have
also shown more increases in this indicator. For example,
in Bihar, child anaemia has increased from 71 to 83
per cent, and that among ever-married women from 49
to 58 per cent. In Uttar Pradesh, it has increased from
74 per cent to 85 per cent. However, some states such
as Jharkhand, West Bengal and other do show a decline
in this indicator.
Except in some states like Punjab, the share of underweight
women is also very high, with the national average at
33 per cent. In rural areas this proportion increases
to 39 per cent.
It has been evident for some time now that concerns
about food security are not relics of the past, but
unfortunately only too contemporary. Such a concern
should now be extended to cover nutrition security,
which seems to be even more under threat. The results
of these recent surveys should certainly cause alarm
bells on the state of public nutrition to ring very
loudly in the corridors of power.
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