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Why childhood under-nutrition persists in India — and how to intervene
Recently, Prime Minister Manmohan Singh released a survey on child under-nutrition in rural India in 2010-11 (Hunger and Malnutrition Survey, HUNGaMA). Sadly, the new data reinforced the existence of an India marked by substantially low levels of something absolutely vital for adequate human development. The survey found that 42 per cent of the under-five children were underweight and 59 per cent were stunted in the 100 focus districts. Remarkably, in six districts with the best child development index, the prevalence of underweight (33 per cent) and stunting (43 per cent) among children, while somewhat lower, was still substantially high — suggesting the endemic and persistent nature of the under-nutrition burden. Even though child under-nutrition remains very high, do the data from HUNGaMA suggest an improvement over previous assessments? Data from the district-level health survey (DLHS) of 2002-2004 provide some answers. The DLHS includes data on underweight among children under six from hundreds of districts across India. In the 100 focus districts, the prevalence of underweight appeared to have reduced 11 percentage points from 53 per cent in the DLHS to 42 per cent in the HUNGaMA Survey. A similar comparison of changes in the prevalence of stunting is not possible since DLHS did not measure the height of children. Other aspects of the results from the HUNGaMA survey reiterate older patterns. For instance, under-nutrition is inversely associated with socio-economic status; thus children from low income households or whose mother had low levels of education have higher prevalence of under-nutrition.
The HUNGaMA report appears to emphasise the gender differences in under-nutrition even though the magnitude of these differences may not necessarily warrant an urgent attention. For instance, the gender differences in the focus districts are 0.4 percentage points (41.4 per cent in girls versus 41.0 per cent in boys) for underweight, 0.5 percentage points for stunting. Similar figures from NFHS-3 are: 1.2 percentage points for underweight, and 0.1 percentage points for stunting. When examined separately by age group, the biggest gender differences in the focus districts are observed with stunting. Girls, compared to boys, enjoy a 6.4 unit advantage between 0-5 months of age, which reduces to a 2-unit advantage in the 6-35 month group and flips to a 1.3 unit disadvantage in the 36-59 month age group. Since stunting is particularly reflective of nutritional circumstances in the first three years of life, one should be cautious interpreting this as a gender disadvantage.
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I use to think it is because of the poverty and illiteracy.