Sunday, 30 June 2013

Food Security Bill and malnutrition in India

Dr. Devendra Kothari
Population and Development Analyst,
Forum for Population Action

Investing in agriculture, reproductive health and living conditions is right thing to manage malnutrition & hunger

India’s high economic growth rate in the past decade has not been fully reflected in the health status of its people. According to the National Family Health Survey-3 (2005-06), 40% of children under the age of three are underweight and 33% of women in the age group of 15-49 have a body mass index below normal. Latest data indicate that things are not improving at all. In fact, things are going from bad to worse. The  Global Hunger Index (GHI) 2011 places India amongst the three countries where the GHI between 1996 and 2011 went up from 22.9 to 23.7, while 78 out of the 81 developing countries studied succeeded in improving hunger condition.[1]  The HUNGaMA (Hunger and Malnutrition) survey carried in 2011 reconfirms that malnutrition among children has taken ominous proportions, and the situation in many districts of the country has worsened when compared to what it was about a decade back. The report reveals that over 40% of children are underweight and almost 60% are stunted. [2] Further, about 34 per cent of girls aged 15 to 19 are stunted in the country, as per The Lancet Maternal and Child Nutrition report. These adolescents, part of the post- economic liberalization generation, have benefited the least from economic growth. Without active intervention to improve their access to appropriate food, the young women are bound to face complications during pregnancy and many are certain to deliver stunted babies, “continuing the distressing cycle”, noted by The Hindu (June 13, 2013) in its editorial  “Stunting a Country”.  These are disturbing facts which point to nutritional deficiencies. 

Given its impact on health, education and economic productivity, persistent under-nutrition is a major obstacle to human development; impacting India´s much awaited demographic dividend and the country’s prospects for future economic growth. It was felt that it should be addressed. The proposed National Food Security Bill 2011 is perhaps the most important national effort yet to address these deficiencies in India.[3]  Is the Bill a right step to resolve issue of malnutrition in India?

Food security implies access by all people at all times to enough food for an active, healthy life. In 2010, the National Advisory Council (NCA) under chairmanship of Mrs. Sonia Gandhi drafted a National Food Security Bill to address nutritional deficiencies of the population by proposing legal entitlements for 75% of the population.  The Bill was forwarded to the Prime Minister of India in October, 2010 for needful.  In January 2011, an Expert Committee examined the Bill and made several recommendations. A draft Bill was circulated for the public feedback in September 2011, and it was introduced in Parliament in July, 2011. The Bill seeks to provide a legal entitlement to subsidized food-grains to 75% of the country's rural population and 50% of urban India. The estimates suggest that around 68% of the country's population (820 million) would get legal entitlement after the bill is enacted. The "priority" group will get rice at a fixed 3 rupees a kg, wheat at 2 rupees a kg and coarse grain at 1 rupee a kg. The general category will get grains at half of the price the government sets for payment to farmers. The annual requirement for rice and wheat under the proposed Bill will be at least 45.6 million tonnes, calculated on a monthly outlay of 3.8 million tonnes, based on the 2011 population. The requirement will increase significantly in coming years since population has been growing by around 17 to 18 million every year.Further, The Bill is expected to cost Government of India an additional Rs. 470,000 million in the year 2014-15.

It is argued that the Bill, an election promise of the ruling party, could ease voter anger at near 10% inflation and give the government a political breather at a time when it is struggling with corruption scandals and policy paralysis. However, some believe that this is right step to manage malnutrition. Talking about the food security Bill , Noble laureate Amartya Sen said that the bill has several flaws yet any initiative taken in the direction of ensuring food security to public is more than welcome. He argues that nourishment is very important for the nation’s development and cited the example of Asian countries which had focused on healthcare and nutrition to propel themselves forward. 

Arvind Panagariya, Professor of Indian economics at Columbia University and former chief economist at the Asian Development Bank, counters Sen's argument that it is high social spending that has contributed to the economic growth of Indonesia, Singapore, Malaysia, Thailand, South Korea and China. He believes that that the food security Bill will not boost food grain consumption for the poor as has been seen in Chhattisgarh and Tamil Nadu since these States already provide households more grain at even lower prices. He thinks that such measures are huge waste of resources.[4] A recent paper by Arvind Virmani, ex Chief Economic Advisor to the Government of India argues that the most important cause of malnutrition in India was the abysmal state of public health in terms of sanitation, pure drinking water and public knowledge about the importance of cleanliness and nutrition.

I agree with Prof. Virani that the Food Security Bill and anti-poverty programs are not the best way to resolve the issues of malnutrition, poverty and hunger. For example, despite its best intentions to provide employment, Mahatma Gandhi National Rural Employment Guarantee Act (MGNREGA), launched in 2006, is beset with controversy about corrupt officials, deficit financing as the source of funds, poor quality of infrastructure built under this program, and unintended destructive effect on poverty.  Further, the major idea behind MGNREGA program was to create as many jobs as possible for people. But between 2009-10 and 2011-12, the proportion of workers slipped in India, as per the National Sample Survey Organization (NSSO).

The Bill will have little or no effect on malnutrition, poverty and hunger. The food security scenario in India has drawbacks in its Public Distribution System. In addition, the grain yield of Indian farmers is not going up and there is growing gap between demand and supply. Per capita availability of food grains and pulses has declined significantly in the last few years.  The availability of food is just not growing.  In the eight years between 1996 and 2004, when agriculture was growing at a low 2%, there was, in fact, zero growth in food-grains.The Food Security Bill has the potential to do serious damage. If the Bill is implemented, it can lead to a situation where small farmers, who primarily farm for self consumption, stop producing food grains altogether, expecting the government to feed them with highly subsidized food grains. So the implementation of the Bill could actually result in an overall reduction in food grain production.  The neglect of government to made adequate investment in the country’s food storage system is another major reason for rising level of threat to the available food to the poor and hungry. The increase in population can be cited as another major reason for the rising food threat in India. India’s population has grown from 361 million in 1951 to 1210 million in 2011,  and is still growing by around 17 to 18 million every year. India’s population is projected to peak at 1700 million in 2060.To feed the large population we require millions of tons of food grain. It is estimated that India would require 343.0 million metric tons of food grains in 2020 to feed the whole population.[5]

However, malnutrition especially child malnutrition can be dramatically reduced, if not eliminated, within a decade by removing structural constraints.   The interaction between agriculture/food policies and socioeconomic factors at the micro and macro-level is now considered crucial to ensuring food availability or security.  What is sincerely required is Government must prioritize agricultural development sincerely investing adequately in research, extension, education, irrigation, processing, markets, infrastructure, among others, and drastically revamping organizational structure of agricultural departments and agricultural universities thereby creating enabling environment that can motivate farmers to increase productivity of crops and net profit. Besides, create rural employment through productive and income generating assets which can increase purchasing power of people to help them purchase food grain, vegetables, pulses, fruits, milk, meat etc from open markets.[6]

In addition, one has to revamp the reproductive health services to reduce the burden of unwanted fertility. The galloping population growth is mainly fueled by unwanted fertility. More than four in ten pregnancies are unintended/unwanted by the women who experience them and half or more of these pregnancies result in births that spur continued population growth.  Around 26.5 million children are born in India every year and out of this about 6 million births have been classified as unwanted. Further, as per the National Family Health Survey-3 about 30% (around 224 million persons) of the total population in the young age group 0-35 years in India was the product of unwanted childbearing. The level of unwanted fertility has increased from 23% in 1992-93 to 30%t in 2005-06, as shown in Table 1.

         Table 1 India:  Level of unwanted fertility, 1992-2006
Level of unwanted fertility or childbearing (%)
No. of persons in age group 0-35 resulting from unwanted fertility
(in million)
Based on data obtained from National Family Health Survey 1, 2 & 3 and Sample Registration Bulletins. For details, see: Kothari, Devendra. 2011. Implications of Emerging Demographic Scenario: Based on the Provisional Results of Census of India 2011, A Brief, a publication of Management Institute of Population and Development, Parivar Seva Sanstha, New Delhi.

It is estimated that around 450 million people out of 1200 million in India in 2011 were the product of unwanted pregnancies, and most of them are from the lower economic strata. The consequences of unintended pregnancy are serious, slowing down the process of socio-economic development as well as process of change, and  is being  reflected in widespread malnutrition, hunger, poverty, unemployment, regressing governance as well as increasing scarcity of basic resources like food, water and space despite concerted developmental efforts since 1991.

Now question arises why unwanted childbearing? Around 15 million currently married women in the reproductive ages in 2011, mostly in poor performing States, seek to postpone childbearing, space births, or stop having children, but are not using a modern method of contraception. Often, these women travel far from their communities to reach a government health facility, only to return home “empty handed” due to shortages, stock outs, and/or non availability of doctors and paramedical staff. When women are thus turned away, they are unable to protect themselves from unwanted/unplanned pregnancies.   Thus, there is an urgent need to revamp reproductive   heath services. 

The provision of basic services such as piped water, sanitation and hygiene (WASH) as well as electricity could be another effective way to handle malnutrition. Available data, however, indicates that   sub-human living conditions in terms WASH factors can be cited as another major cause of malnutrition.[7]  Only 47% of households have source of water within the premises in 2011. In addition, poor water supply has obvious health costs, since only one in three households are supplied ‘treated’ water in the country.   This problem is further compounded by lack of access to sanitation. About half of total households in India still defecate in open. This situation is particularly piquant for women and girls.  It is estimated that around 290 million women in India in 2011, the worst sufferers of open defecation, continue with the age-old practice even after 20 years of economic reforms. Nearly 65% households in rural India do not have drainage connectivity and the risk of seepage of waste water into the hand pumps and tube wells is quite high. Research on health outcomes suggests that both the quality and the quantity of water are important determinants of the prevalence of gastrointestinal diseases and improving the maternal and child health. Improvements in environmental sanitation are the clearest and most effective policy program tool to reduce, if not eliminate, the excessively high levels of malnutrition in India.

Along with above interventions, sensitizing the society to change its mind-set about importance of cleanliness and nutrition should also be put into action throughout the country with a special focus on the problem districts and communities. Also, the need of the hour is raising civic sense and teaching the right values through mainstream entertainment channels, the media and so on. Further, it is known fact that an educated female/mother changes the health, nutrition and economic status of not only of the entire family but also of the community/nation.   A recent paper by Economist Nisha Malhotra of University of British Columbia shows that lack of knowledge on nutrition and not just access to food plays a vital role in keeping children malnourished. The same also applies to adult malnutrition.

In short, provision of food to people by significantly subsidized rate is not the remedy in longer term. What is sincerely required is Government must prioritize its options. The political class is facing a very perplexing dilemma. It has arrived at a decisive movement of history where it must choose between the antiquated (or populist) and dynamic options available to it. It is time that we take cognizance of the fact that antiquated measures does not help anyone.  As the country’s voter profile increasingly turns young, the political class has to focus on real issues, as noted above, to fight malnutrition, hunger and poverty.

[3] The Government of India on June 13, 2013 deferred a decision on a proposal to promulgate an ordinance on the Food Security Bill. 
[4] Refer:  Arvind Panagariya, “A Waste of Resources: Why the food security Bill will not boost food grain consumption for the poor”, Times of India, June 1, 2013 
[5] Refer: Food Security: Need to establish food democracy, CIVIL SERVICES TIMES MAGAZINE, 30 JULY 2011
[6] Refer: Food Security: Need to establish food democracy, CIVIL SERVICES TIMES MAGAZINE, 30 JULY 2011
[7] See post on: “Quality of life and living environment in India” dated September 30, 2012 by the author at the link: Also see article by the author “West Bengal: Household amenities with special reference to water, sanitation and hygiene (WASH) and their implications”, UNICEF West Bengal, Kolkata, 2012.

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