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.
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
Year
|
Level of unwanted fertility or childbearing
(%)
|
No. of persons in age group 0-35 resulting
from unwanted fertility
(in million)
|
1992-93
|
22.1
|
140
|
1998-99
|
25.5
|
178
|
2005-06
|
29.6
|
218
|
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.
[1] For details, see: 2011 Global Hunger Index Report, International Food Policy Research Institute.
[2] For details, refer:
URL:[http://hungamaforchange.org/HungamaBKDec11LR.pd.
[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: kotharionindia@blogspot.com. 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.
