MALNUTRITIONED INDIA

IIITAB2K12B • Pratyush Vashishat • Sagar Sahni • Agam Gupta • Pankaj Wadhwani • Shubham Sharma

Theme: Nourish to Flourish:

Reducing malnutrition

INTRODUCTION

India, today is one of the most malnourished countries in the World.

More than 40% of the World’s under weight children below five years live in India (Global Hunger Index 2007)

The latest NFHS 3 asserts that not much progress has been achieved in improving human resources.

Poverty is a major, but not the only cause of malnutrition

Percentage of population suffering from various forms of malnutrition, far exceeds the percentage below poverty lineToday, India has no national program to combat malnutrition

2

(i) India has no comprehensive National Program for the eradication of Malnutrition. The ICDS programme in governmental and general perception is seen as a programme to address malnutrition. However, ICDS is not a programme for the eradication of malnutrition, but for Integrated Child Development.

(ii) Other Nutrition and related programmes such as the Mid Day Meal Programme, Kishori Shakti Yojana, Vitamin A supplementation programme, National Nutritional Anemia Control Programme, and the National Iodine Deficiency Disorder Control Progreamme address some of the causes of Malnutrition but not all of them.

(iii) Malnutrition in India is deeply rooted in the inter-generational cycle. However, the current policies and programmes do not address the issue inter-generationally, as depicted in the diagram.

3

Analysis of the current situation:

(iv) The population of India suffers from a high Protein Calorie deficit. Studies reveal that 30% of the households in India consume less than 70% of the energy requirement and calorie intake(NNMB repeat surveys 1988-1990 and 1996-97).

(v) There is inadequate awareness and information regarding proper nutritional practices amongst the population.

(vi) Crucial prescriptions of the National Nutrition Policy, 1993, were not translated into National Programmes, viz., popularization of low cost nutritious foods, reaching the adolescent girl, fortification of essential foods and control of micronutrient deficiencies.

(vii) Most importantly, eradication of malnutrition should be articulated as high priority in the National Development Agenda.

4

Analysis of the current situation:

Male malnutrition intrinsically begins with maternal malnutrition

28.1% of the men in India have Body Mass Index below normal

Stunted stature and low body weight of men due to malnutrition results in Chronic Energy Deficiency

24.3% of the men in India are anaemic

Anaemia reduces work capacity and results in low productivity

Percentage of men suffering from anaemia ranges from 7.1% in Kerala to 44.6% in Assam

Percentage of men having below normal BMI and suffering from anaemia is higher in SC and ST population.

5 Cont… 5

Nutritional Status of Men in INDIA

Malnutrition negatively impacts the GDP as it reduces physical/ cognitive growth, reduces productivity and earnings of individuals, and results in economic loss to the nation.

It lowers the resistance of the body to infections and capacity to recover from illness and adds to the health costs of the nation.

Protein Calorie Intake, Micronutrient Intake, Infections and illness, Nature of Occupation determine working capacity and income generation capacity

Based on the findings of NNMB repeat surveys in the years 1988-90 and 1996-97, that 30% of the households consume less than 70% of energy requirement, an attempt has been made to calculate loss of productivity in adults, and the resultant economic loss to the nation as a result of malnutrition. This equals approximately US $ 72 Billion (4% of GDP).

Other studies conducted by Administrative Staff College of India in the year 1996, CARE India and Linkages India 2003, confirm that 3% of GDP is lost on account of malnutrition and its various types of manifestations.

6

What Does Malnutrition Cost The Nation

Total no. of households in India= 193,579,954 (Census of India 2001)

30% of households =58,073986 consume less than 70% of energy

requirements (NNMB Repeat Surveys in 1988-90 and 1996-97)

Norm level of calorie intake: 2700Kcal

Actual Calorie Intake: 1890 Kcal (70% of 2700Kcal)

Energy required for Basal Metabolic Rate (BMR): 1515 Kcal

Calorie left for productive work: 375 Kcal (1890 Kcal- 1515 Kcal)

Heavy work requires 219 Kcal per hour.

Moderate work requires 122 Kcal per hour.

Work hour lost per day per person due to inadequate calorie

consumption: 4 hours of moderate work and 7.5 hours of heavy

work

GDP Loss Due To Calorie Deficit

Calculated on the formula:

Ea X Total No. of days in year (365)

Er X Total No. of working days in year (250)

Ea: is the Energy available for work: 375 Kcal

Er: is the energy required for a particular work: 219 Kcal for heavy work and 122 Kcal for moderate.

Assuming average household has 5 Consumer Units,(NSS in Nutritional Intake in India, 50th Round, July 1993: June 1994) then total no. of population consuming less than norm level for calorie intake= 290,369,930

55% of Adults= 159,703,461.

Based on actual average wage of Rs. 240/- per man per day of 8 hours, per hour earning = Rs. 30/-

Loss of total money due to low productivity due to inadequate calorie consumption = Rs. 120/- approx. per day per person.

Total money lost by entire adult population per day= Rs. 19,164,415,320

GDP Loss Due To Calorie Deficit

Assuming total of 250 working days, total money lost in a year = Rs. 4,761,775,920,000 = US$ 72,148,120,000 approx. (1 US$= Rs. 40/-) = Approx. US $ 72 Billion

Total GDP for year 2012-13 = (approx.) US$ 1.8 trillion

GDP loss = 4% GDP

In absence of reliable data this study does not take into account the productivity loss through protein and micronutrient deficit.

GDP Loss Due To Calorie Deficit

Adolescents learn better & achieve higher

grades in school

Girls & women are well-

nourished and have healthy

newborn babies

Families & communities emerge out of

poverty

Communities & nations are

productive & stable

The world is a safer, more resilient &

stronger place

Young adults are better able

to obtain work & earn

more

Because when..

Children receive proper nutrition

and develop strong bodies &

minds

WHY NUTRITION…??

Underlying Principles: Bridging the Calorie-Protein Gap

Introduce nutrition and micro-nutrient interventions for the three critical links of malnutrition viz. children 6 months – 6 years, adolescent girls, and pregnant and lactating women to be prepared by SHGs from low cost, locally available agricultural produce.

Introduce nutrition and micro-nutrient interventions for the general population to bridge the protein-calorie gap by making available in the market, protein-energy dense foods.

Make available low cost energy foods for the general population (Corporate Sector/PPP)

Structure and monitor tightly integrated multi-sectoral interventions to address all or majority of the direct and indirect causes of malnutrition simultaneously.

Initiate a sustained general public awareness campaign regarding proper nutritional practices within existing family budgets, and to create demand. 11

A National Strategy To Combat Malnutrition

A computerized Central and Block level monitoring systems should be devised with deliverable targets and time frames

An effective concurrent monitoring system through an external agency can also be established for measuring outcomes, and for effecting changes and mid course corrections

At the AW level, community based nutrition monitoring and surveillance through ICDS infrastructure could include growth monitoring of infants and children and weight monitoring of adolescent girls and women

Creating a data base on the nutritional status of children, adolescents and women in each Anganwadi

12

Nutrition Monitoring and Surveillence

Since at least 4% of India’s GDP ($1800 Billion) annually is lost on account of malnutrition, the cost of addressing malnutrition is far below the cost of not addressing it.

It may be noted that the cost of construction of 3 kilometres of rural road is in excess of the amount required to address the nutrition deficit of the key target groups in the Block.

Investing in human resources development for the future – in the shape of healthy children, adolescents and adults with higher cognitive and productive capacity, is an investment that will pay for itself several times over, will eradicate the curse of malnutrition in the shortest possible time, so that every Indian is able to reach his or her full physical and cognitive potential, enhance income generation capacity and contribute to the country's progress.

13

Concluding Observations

References

• http://www.cini.org.uk/childmalutrition.pdf • http://www.slideshare.net/pvashishat/savedfiles?s_title=malnutri

tion-among-indian-children&user_login=mphbharti • http://www.economist.com/node/17090948 • http://www.slideshare.net/mphbharti/malnutrition-among-

indian-children • https://www.google.co.in/search?q=reducing+malnutrition+ppt&

aq=f&oq=reducing+malnutrition+ppt&aqs=chrome.0.57.7217j0&sourceid=chrome&ie=UTF-8#q=reducing+malnutrition+india+ppt&spell=1

• http://nutritionfoundationofindia.res.in/fao%202007/FAO2007/11%20Summary%20and%20Conclusion/11%20Conclusion%20.pdf

• http://en.wikipedia.org/wiki/Economy_of_India