Malnutrition continues to pose a major health challenge, especially for children in India. Severe malnutrition due to low food intake has impaired their growth rate and overall health status continues to be poor. According to the National Family Health Survey, it is estimated that about 38.4% of children below three years are stunted, while 46% are underweight. The survey also found that 79.2% of children, both girls and boys below five are also severely undernourished and anaemic because of poor diet, unhygienic environment where they reside and limited access to essential drugs like iron and folic acid tablets or vitamin supplements.
A significant number of malnourished children are found in rural areas where access to nutritious diet and availability of a variety of quality food products is negligible due to which approximately 60 percent of children are either stunted, wasted or extremely underweight. In some children, it was also found that their cognitive ability is also compromised because they are severely undernourished.
A government survey in several districts in the state of Jharkhand found that the water quality in villages and remote areas where tribal communities reside was extremely polluted. These areas are not covered under the drinking water supply schemes nor do they have drainage systems for waste water discharge and sanitation in their habitations so water stagnates near their homes. Besides, their main source of drinking water is from hand pumps and wells, which are not maintained and are often soiled. In villages where hand pumps are not available, families use drainage water for consumption, which has a severe impact on health.
Since the quality of diet is compromised, families, especially children living in these unsanitary and unhygienic conditions suffer from chronic diseases such as diarrhoea, typhoid, malaria, measles and pneumonia. They survey found that millions of children die due to these multiple illness before they turn five. It is estimated that every day, 1000 children die due to diarrhoea, because sanitation in their area is poor.
The government’s ICDS programme launched to supply food grains and pulses to anganwadi centres at the village level, so that infants and children below six years are given mid day meals on a daily basis, boosting their health. However, in many areas several gaps have been found. Rations such as grains, pulses were not provided on time. Anganwadi staff says they have to wait for months to get the ration. Many children are therefore deprived of their daily meals impacting their overall health and growth.
Also, while efforts have been made to create awareness in the community level about the need for nutritious food for enhancing the growth of in areas where malnutrition is rampant through Village Health and Nutrition Day (VHND) where local ASHAs, health volunteers provide health care information to families about how to address malnutrition and keep their children safe and healthy, malnutrition remains a threat for children. There are multiple reasons for this. Primarily, many families do not have enough finances to obtain quality food products. The other challenge is that the quality of food products in their own habitats is affected because of the nature of farming done.
Farmers use toxic fertilizers and pesticides for farming in their fields to promote crop growth. However, these chemicals contaminate soil, ground water and food crops as well, which has a direct impact on nutrition and health in the community especially among infants and children below five years.
Providing better Nutrition by improving Quality of Food Products
To provide better nutrition and health for infants and children for their growth and development, every family should have adequate food basket which should include healthy diet should include a wide variety of nutritious food for sufficient intake of all nutrient rich foods.
However, for food to be nutritious depends on the quality of food products. For every child to get affordable and quality foods, there is also the need for better and higher outputs of food products for which there is an urgent need to oversee food safety to prevent unsafe and poor quality from reaching the public. This can be possible if food manufacture in the community is sustainable and there is a process of overseeing and regulating the quality of ingredients in food products so that the food intake is adequate and does not pose any growth or health threat. To achieve this and it is essential to assess the soil quality and improve water quality in agricultural production as well as in the food systems so that food quality is not affected.
It is also imperative that there is adequate provision of clean water resources both for agriculture as well as households so that their health and growth are not compromised. Clean environment will prevent water borne infectious diseases like diarrhoea, typhoid, and malaria.
In terms of farming, since pesticides and chemical fertilizers play an important role in contaminating both crops and water, there is a need for a paradigm shift in agriculture for creating better food systems. To address the impact on food crop production, the environment where food production is done needs to be addressed since it impacts the quality of food products. Consumers have a right to expect that the foods they purchase and consume will be safe and of high quality.
Besides, in order to meet the needs of people and address the gaps there also needs to be an increase in the production of food grains, pulses, vegetables to prevent malnourishment. For that, economic incentives are needed for them to sustain their productivity. If no incentives are given then their poor financial condition can only continue to cause damage to the quality of food and nutrition, especially in the under privileged region. Families, who are disadvantaged, will continue to face inequity and will not be able to obtain healthy foods since they will not be affordable leaving them undernourished.
Since the quality of food and nutrition is linked with health, poor diet can lead to chronic diseases. To break the mould of malnutrition, poor health and high mortality rate in children, it is critical that the government takes measures that will help reduce inequity in healthcare and end this battle against malnutrition.
Steps such as providing better agricultural support, clean water and sanitation and other resources such as availability of adequate and affordable food grains, pulses and other nutritious products like fruits and vegetables, which are low in calories and nutrient dense, and high in vitamins, minerals, antioxidants and fiber across all sectors, especially in regions where communities are extremely disadvantaged and overall support to mothers, newborns and children to ensure their food intake is appropriate can not only bring down the widespread malnutrition in India significantly, help save millions of lives and provide overall development and growth in infants, children and adolescents. Only then can the battle against malnutrition be won.
(Mohuya Chaudhuri is a journalist and researcher)