Despite
rapid economic growth, the nutritional status of our
population appears to be worsening according to some
important indicators. This is what seems to be emerging
from major national-level surveys conducted by official
organisation such as the 61st Round of the national
Sample Survey, conducted in 2004-05, and the third
National Family Health Survey conducted in 2005-06.
Remember that these years
are part of a period of economic boom, the period
when the Indian economy (and therefore presumably
Indians) have never had it so good. Aggregate GDP
growth rates have been around 8 per cent on average
and per capita GDP has increased by around 6 per cent
per year. In this ''take-off phase'' it would be normal
to expect that calorie consumption and nutritional
indicators would show some improvements, even if not
dramatic improvements, at least substantial.
But the data from the National Sample Survey Rounds
on consumption expenditure tells us that per capita
calorie consumption, far from rising, has actually
decreased, even for the poorest groups. Per capita
foodgrain consumption declined from 476 grams per
day in 1990 to only 418 grams per day in 2001, and
even aggregate calorific consumption per capita declined
from just over 2200 calories per day in 1987-88 to
around 2150 in 1999-2000. The latest NSS survey suggests
further declines in calorie consumption.
This cannot be entirely a sign of people moving towards
different (and qualitatively better) consumption patterns
through different food choices, as some analysts have
argued. Instead, it is more likely to reflect shifts
in wage incomes, relative prices and increasing costs
of health and other essentials, that have reduced
the ability of households to spend more on food.
The worst aspect is that this is happening in a context
of already very poor standards of nutrition on average.
The NFHS-3 provides some depressing reminders of the
low and in some cases worsening nutrition status of
most of our citizens, especially the young.
Take the proportion of children below 3 years of age
who are underweight. This indicator shows very little
improvement, especially when compared to the 1996-97
survey, and the proportion of underweight children
remains appallingly high at 46 per cent for the country
as a whole.
It is predictably higher in the more economically
backward states, such as Madhya Pradesh with 60 per
cent, Bihar with 58 per cent, Jharkhand with 59 per
cent and Chhattisgarh with 52 per cent. What is worth
noting is that in several of these states, the proportion
of children actually increased between 1996-97 and
2005-06! In Bihar it went up from 54 to 58 per cent;
in Jharkhand the increase was from 54 to 59 per cent.
However, such a degeneration was not confined to the
poorer and more backward states, from where we have
got inured to hearing bad news. It happened also in
some of the more prosperous states. Thus, in Gujarat,
which is one of the richest states and has shown one
of the highest rates of economic growth over this
period, the proportion of underweight children also
increased slightly even between 1997-98 and 2005-06,
from 45 to 47 per cent.
The statistics on anaemia are even worse. Not only
are the data on the prevalence of anaemia alarmingly
high, but they have actually got significantly worse
since the mid 1990s. In the latest NFHS survey, nearly
4 put of 5 children in the age group 6 to 35 months
had anaemia, while nearly 3 out of every five ever-married
women and pregnant women also were anaemic. The prevalence
of severe anaemia also remains high.
Data on anaemia provide some evidence of the quality
of nutrition, and therefore address the point that
some analysts try to make about calorie consumption
or even weight for age/height not being correct indicators.
If even anaemia is on the increase in the country
as a whole, especially among vulnerable categories
such as children and pregnant women, we must have
serious concerns about the inadequate nutrition we
are providing our citizens.
There is an evident gender gap in operation here as
well: for adults, while anaemia is high among both
sexes, it is very high among women, with the prevalence
of anaemia among women more than double that among
men in almost all states. Once again, the states with
the highest levels of anaemia among the population
have also shown more increases in this indicator.
For example, in Bihar, child anaemia has increased
from 71 to 83 per cent, and that among ever-married
women from 49 to 58 per cent. In Uttar Pradesh, it
has increased from 74 per cent to 85 per cent. However,
some states such as Jharkhand, West Bengal and other
do show a decline in this indicator.
Except in some states like Punjab, the share of underweight
women is also very high, with the national average
at 33 per cent. In rural areas this proportion increases
to 39 per cent.
It has been evident for some time now that concerns
about food security are not relics of the past, but
unfortunately only too contemporary. Such a concern
should now be extended to cover nutrition security,
which seems to be even more under threat. The results
of these recent surveys should certainly cause alarm
bells on the state of public nutrition to ring very
loudly in the corridors of power.