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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