FLAIR (Forum for Learning and Action with Innovation and Rigour), has now reported that India ranks amongst  the top 6 nations having malnourished children and leads in yearly death incidence of children below 5 years.

In its policy paper on  malnutrition co-authored by Dr Raj Bhandari and Ajay Kumar Sinha, FLAIR highlights that India continues to have the dubious distinction of being a leading country on many malnutrition and mortality indicators.

Malnutrition dimensions have now reached a situation of alarm with over  50 per cent reporting  malnutrition or micronutrient deficiency, resulting in suboptimal cognitive and physical development, low productivity and high health care costs. In 2012 there were 14 lakh under-five deaths in India.

Malnutrition amongst children is a factor of household level food and nutrition insecurity, lack of health care and extremely poor conditions of public health including water, sanitation and hygiene. Lack of basic sanitation in India, especially in high-density areas is one of the key reasons for severe child malnutrition burden among indigent poor and backward groups. Kerala, Manipur, Mizoram and Sikkim, where 80 per cent of the rural population had  access to toilets, had  lowest levels of child malnutrition in India. Conversely, Madhya Pradesh, Bihar and Jharkhand top the list with as high as 85 per cent home in Bihar, 86.9 per cent in Madhya Pradesh and 77 per cent of homes in Jharkhand having no toilet facilities where child malnutrition rates are also the highest. Bihar, Jharkhand, and MP are among the worst performing states in terms of improvement on malnutrition indicators.

There has been in general an increase in allocation in food and nutrition programmes between FY 2011-12 and FY 2014-15. But the shares of nutrition schemes in total Union and respective State Budgets have been highly inadequate considering the grim status of malnutrition.

According to Dr Bhandari, who  is also the  chairperson of Health and Nutrition Committee of Indian Council of Child Welfare (ICCW), unhygienic environment combined with high population density creates diseases to thrive, and malnutrition to flourish. The absence of sanitation exposes children to infectious diseases such as typhoid and diarrhea, which weakens the immunity system, and resulting in  their inability to absorb nutrients.  

“The 14th Finance Commission has recommended that the State share of untied funds has increased from 32 per cent to 42 per cent. This is a welcome move in the sense that each state can now develop state specific approaches, based on emerging lessons of successful state experiences, for effective implementation of the plans”, said Sinha.

The policy paper also suggests that there is need to introduce nutrition as a development indicator in various other schemes such as the Integrated Child Protection Scheme (ICPS) and Integrated Child Development Scheme (ICDS). There is also an urgent need for a reliable system on periodic data on nutrition. Besides, prioritize universal coverage essential nutrition interventions (ENIs), with special focus on children under 2 years of age, pregnant women and adolescent girls.