3.1 million children under five die of malnutrition annually


Jyotsna Singh
Issue Date: 

Study says child mortality linked to maternal undernutrition, obesity

Forty-five per cent of deaths of children below the age of five globally are attributed to malnutrition, says a study published as part of a compendium of research papers from The Lancet. The study looks at maternal and child undernutrition and overweight in low- and middle-income countries (LMICs) and calls for an enabling environment to tackle malnutrition and incorporate specific nutrition goals and actions.

The authors of the paper led by Robert Black, professor, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA, performed a comprehensive analysis of the different causes of maternal and childhood malnutrition, including poor breastfeeding practices and deficiencies of vitamins and minerals such as vitamin A, zinc, iron and calcium. They also analysed the consequences of malnutrition, including stunting (low height for age), wasting (low weight for height), and underweight (low weight for age), all of which result in increased risk of death and illness for both pregnant women and children.

Mother’s health matters

image [1]

The research links child mortality to maternal health, with iron deficiency in mothers associated with low birth weight (<2,500g) in babies. Maternal undernutrition also restricts the growth of the baby in the womb and is responsible for a quarter of child deaths. The study finds children born too small–27 per cent in LMICs–are at a substantially higher risk of dying. Maternal short stature and underweight also limit foetal growth and cause 12 per cent of neonatal deaths. Suboptimum breastfeeding too is associated with deaths of more than 800,000 children annually.
According to the researchers, India’s biggest problem is the number of young anaemic mothers–55.8 per cent of adolescents aged between 15 and 19 years and 56.7 per cent of women aged between 20 and 24 years were found to be anaemic. In contrast, corresponding values for Guatemala were 21.0 per cent and 20.4 per cent respectively. Eleven per cent of adolescent girls in India were found to be underweight.

“Currently, only 0.4 per cent of aid is spent combating malnutrition despite it being the leading cause of child deaths,” says Ishaprasad Bhagwat, doctor and health manager with non-profit Save the Children, India.

Stunting still high

The global prevalence of stunting has gradually decreased in the past 20 years, but still remains high in absolute numbers. The researchers estimate that stunting affected at least 165 million children worldwide in 2011. In the same year, at least 50 million children were affected by wasting and 100 million children were underweight. Over 90 per cent of these were in Asia and Africa. Africa is the only major region in the world where the number of stunted children has increased in the past decade.

The authors correlate the prevalence of stunting to equality in different countries. Nigeria showed no change in prevalence of stunting from 2003 to 2008, and the degree of inequality, too, remained almost unchanged. Bangladesh demonstrated a decrease in the prevalence of stunting, though inequality levels remained unchanged. Brazil showed a much lower prevalence of stunting. The researchers thus concluded that equality in the country improved because of a substantial decrease in stunting in the poorest populations.

Obesity brings risks

The research demonstrates that obesity is fast becoming a cause for child undernutrition and mortality. The prevalence of maternal overweight has steadily increased since 1980 and exceeds that of underweight in all regions of the world. Obese pregnant women, whose body mass index is more than 30 kg/m2, are four times more likely to develop gestational diabetes and two times more likely to develop pre-eclampsia. During labour and delivery, maternal obesity is associated with maternal death, haemorrhage, caesarean delivery, or infection; and a higher risk of neonatal and infant death, birth trauma, and macrosomic infants. In the post-partum period, obese women are more likely to delay or fail to lactate and have more weight retention than women of normal weight.

The framework of the report is an improvement on the 2008 conceptual framework of the United Nations Children’s Fund (Unicef), which was also prepared under Black’s lead. The new framework shows the dietary, behavioural and health determinants of optimum nutrition, growth and development. It analyses how they are affected by policies related to food security, care giving resources and environmental conditions. Apart from immediate reasons related to maternal and bodily health of a child, the new framework also encompasses “economic and social conditions, national and global contexts, resources, and governance”.

The paper has been published in the Lancet series on maternal and child nutrition 2013 that was released on June 6.  


Source URL: http://www.downtoearth.org.in/content/31-million-children-under-five-die-malnutrition-annually


India loses up to $46 billion to malnourishment #WTFnews

Malnourished child

Malnourished child (Photo credit: Wikipedia)


Issue Date:

Report by children’s non-profit links childhood malnourishment to educational performance, adult income and GDP


Malnutrition decrease the gross domestic product (GDP) in low- and middle-income countries, says a report by international non-profit Save the Children. Malnutrition affects educational development, physical productivity and health, and also perpetuates inequalities, such as those created by caste in India, says the report.

The report, Food for thought: Tackling child malnutrition to unlock potential to boost prosperity, is based on a study conducted in four countries—India, Vietnam, Peru and Ethiopia. It argues that investment in preventing malnutrition in women and children would be the down payment for future prosperity.

The study estimates that the economic cost of micro-nutrient malnutrition costs India between 0.8 per cent and 2.5 per cent of its GDP, which is equivalent to $15–46 billion. China, too, loses between 0.2 and 0.4 per cent of GDP, equivalent to $15– 29 billion because of malnutrition.

The study looks at various pathways of malnutrition, and elaborates on the cognitive and physical impacts on children, as well as additional medical costs due to ill health. These cumulative effects can reduce GDP by 2 per cent to 11 per cent.

Hindrance to inclusive growth

This study is the first of its kind to link child malnutrition to educational outcomes. Children who are malnourished from an early age are severely disadvantaged in their ability to learn.

The lack of proper nutrition for pregnant women, breastfeeding mothers and young children, especially before their second birthday can impair the child’s brain development, cognitive abilities and physical development, leading to stunting or reduced growth. Brain drain

In comparison to children who are provided with proper nutrition, children malnourished at age five would be expected to demonstrate the following impacts of malnutrition three years later:
They score 7 per cent lower in maths tests
Such children are19 per cent less likely to be able to read a simple sentence at the age of eight
They are 12.5 per cent less likely to be able to write a simple sentence
They are 13 per cent less likely to be in the appropriate grade for their age at school

The report clearly links child malnutrition to educational outcomes, and demonstrates that children who are malnourished from an early age are severely disadvantaged in their ability to learn. These children later in life go on to earn 20 per cent less that other adults who are well-nourished in their childhood.

In effect, malnourishment perpetuates the cycle of poverty, as poverty-stricken and malnourished mothers have stunted children. The report states that children born to the poorest of families in developing countries are 2.8 times more likely to be malnourished than those in the richest, and are likely to go on to earn less than their better-off and better-nourished peers.

Thus the unequal social prevalence of malnourishment acts as a barrier to inclusive growth and the reduction of inequalities.

In India, the problem of malnourishment is helping to perpetuate the caste system, says the report. It goes on to say that if nutritional inequalities were tackled in such a way that low-caste children gained the same average nutritional status as their upper caste counterpart, this would close existing caste cognitive differentials by 25 per cent.

Hard facts

According to the report, State of the World’s Children, 2012, by United Nations Children’s Fund (UNICEF), 47 per cent children under five in South Asia and 39 per cent under-fives in sub-Saharan Africa are stunted and their potential severely damaged. In Nigeria, 10.9 million children under five are stunted while in India, the figure is 61.4 million.

As many as 19,000 children continue to die worldwide each day from diseases which could have been easily prevented. Malnutrition is responsible for 2.3 million children’s deaths annually, and 130 million malnourished children who managed to reach school failed to learn even basics and are left without core skills and abilities they need to make their lives more productive.

The report suggests that direct nutrition interventions, such as promoting breastfeeding, and indirect nutrition interventions, such as social protection, investments in agriculture, and ensuring access to safe water and sanitation, can address malnutrition’s underlying causes.

Source URL: http://www.downtoearth.org.in/content/india-loses-46-billion-malnourishment


Hunger Stalks Temple Town Of Varanasi

While district administration of Varanasi says that the children died of tuberculosis, human rights’ activists allege that the deaths were due to hunger and malnutrition
Virendra Nath Bhatt


May 15, 2013

Illustration: Anand Naorem

Two children from a poor family of weavers have allegedly died of starvation in Varanasi. Four-year old Mohammed Murtaza died on 9 May, while his sister Shamim Parveen (14) died the next day in the Bajardiha locality of Varanasi. Their father, Abdul Khaliq died 10 months ago of malnutrition. He was unable to pay bills for his medical treatment.

While the district administration of Varanasi says that the children died of tuberculosis, human rights’ activists allege that the deaths were due to hunger and malnutrition.

“Both children died due to extreme poverty,” says Mukhtar Ahmed, owner of the loom where Abdul Khaliq worked. “Naazra, mother of the four children, worked at my loom weaving sarees. She earned Rs 25 to Rs 50 everyday and was dependent on her neighbours financially. The children searched for food in garbage dumps.”

But the district administration of Varanasi has denied that the deaths took place due to starvation. “Two doctors examined the bodies of the children and certified that both were suffering from tuberculosis. After all, we have to accept what is being diagnosed by the doctors,” said Additional DM of Varanasi, Mangal Prasad Singh.

Endorsing the official stand, Varanasi City President OP Singh said, “The family was very poor, but the cause of death was not starvation, it was lack of proper medical treatment. Opposition parties are politicising the issue for obvious political gains.”

However, soon after the death of the two children, Naazra was rewarded with a Weaver Card, a BPL Card, foodgrains, kerosene oil and a flat built under the ‘Kanshiram Sahree Garib Avas Yojna’ scheme of the Mayawati regime.

Shruti, head of a human rights organisation, working among weavers in Varanasi says that Naazra had an Above Poverty Line (APL) card. However, soon after the death of her two children, the district administration lost no time to issue her a BPL card. The Weaver Card will enable her to avail the benefits of welfare schemes.

Questioning the ‘benevolence’ of the district administration, Shruti said, “If the family was not under extreme poverty and malnutrition, why have they been given a BPL card, Weaver Card and food grains? How can the district administration claim that the two children died of the disease when the post mortem of the bodies was not conducted?”

She maintained that the Naazra family suffered from extreme poverty and malnutrition. Whatever little Naazra earned as a saree weaver, went in purchasing foodgrains. The family was dependent on doles from neighbours, but the financial condition of neighbours was also not good.

“This is not the first time such an incident has happened in Varanasi. Several such incidents have occurred in the past where poor weavers died of starvation, but no government in UP ever admitted to the deaths,” says Shyamdeo Rai Chowdhary, BJP MLA from Varanasi. He added, “One time assistance of foodgrains and kerosene oil is no solution – the government should run a state-wide programme identifying the vulnerable poor in rural and urban areas.”

– See more at: http://tehelka.com/hunger-stalks-temple-town-of-varanasi/#sthash.c3Tt5PcX.dpuf


We Don’t Need Genetically Engineered Bananas For Iron Deficiency

By Vandana Shiva


Saturday, April 27, 2013

The latest insanity from the genetic engineers is to push GMO bananas on India for reducing iron deficiency in Indian women.

Nature has given us a cornucopia of biodiversity, rich in nutrients. Malnutrition and nutrient deficiency results from destroying biodiversity, and with it rich sources of nutrition.

The Green Revolution has spread monocultures of chemical rice and wheat, driving out biodiversity from our farms and diets.

And what survived as spontaneous crops like the amaranth greens and chenopodium (bathua) which are rich in iron were sprayed with poisons and herbicides. Instead of being seen as iron rich and vitamin rich gifts, they were treated as “weeds”. A Monsanto representative once said that Genetically Engineered crops resistant to their propriety herbicide Roundup killed the weeds that “steal the Sunshine”. And their RoundUp Ads in India tell women “Liberate yourself, use Roundup”. This is not a recipe for liberation, but being trapped in malnutrition.

As the “Monoculture of the Mind” took over, biodiversity disappeared from our farms and our food. The destruction of biodiverse rich cultivation and diets has given us the malnutrition crisis, with 75% women now suffering from iron deficiency.

Our indigenous biodiversity offers rich sources of iron. Amaranth has 11.0 mg per 100gm of food, buckwheat has 15.5,neem has 25.3,bajra has 8.0,rice bran 35.0,rice flakes 20.0bengal gram roasted 9.5,Bengal gram leaves 23.8 ,cowpea 8.6,horse gram6.77, amaranth greens have upto 38.5,karonda 39.1,lotus stem 60.6, coconut meal 69.4,niger seeds 56.7,cloves 11.7,cumin seeds 11.7.mace 12.3,mango powder (amchur) 45.2,pippali 62.1,poppy seeds 15.9,tamarind pulp 17.0,turmeric 67.8, raisins 7.7……..

The knowledge of growing this diversity and transforming it to food is women’s knowledge. That is why in Navdanya we have created the network for food sovereignty in women’s hands – Mahila Anna Swaraj.

The solution to malnutrition lies in growing nutrition, and growing nutrition means growing biodiversity, it means recognizing the knowledge of biodiversity and nutrition among millions of Indian women who have received it over generations as “Grandmothers Knowledge”. For removing iron deficiency, iron rich plants should be grown everywhere, on farms, in kitchen gardens, in community gardens, in school gardens, on roof tops, in balconies….Iron deficiency was not created by Nature. And we can get rid of it by becoming co-creators and co-producers with Nature.

But there is a “creation myth” that is blind to nature’s creativity and biodiversity, and to the creativity, intelligence and knowledge of women. According to this “creation myth” of capitalist patriarchy, rich and powerful men are the “creators”. They can own life through patents and intellectual property. They can tinker with nature’s complex evolution over millennia, and claim their trivial yet destructive acts of gene manipulation “create” life, “create” food, “create” nutrition. In the case of GM bananas it is one rich man, Bill Gates, financing one Australian scientist, Dale, who knows one crop, the banana, to impose inefficient and hazardous GM bananas on millions of people in India and Uganda who have grown hundreds of banana varieties over thousands of years in addition to thousands of other crops.

The project is a waste of money, and a waste of time. It will take 10 years and millions of dollars to complete the research. But meantime, governments, research agencies, scientists will become blind to biodiversity based, low cost, safe, time tested, democratic alternatives in the hands of women.

Bananas only have 0.44mg of iron per 100 grams of edible portion. All the effort to increase iron content of bananas will fall short of the iron content of our indigenous biodiversity.

Not only is the GM banana not the best choice for providing iron in our diet, it will further threaten biodiversity of bananas and iron rich crops, and introduce new ecological risks.

First, the GM banana, if adopted, will be grown as large monocultures, like GM Bt cotton, and the banana plantations in the banana republics of Central America. Since government and Aid agencies will push this false solution, as has happened with every “miracle” in agriculture, our biodiversity of iron rich foods will disappear.

The idea of “nutrient farming” of a few nutrients in monocultures of a few crops has already started to be pushed at the policy level. The finance Minister announced an Rs 200 crore project for “nutri farms” in his 2013 budget speech.

Humans need a biodiversity of nutrients including a full range of micronutrients and trace elements. These come from healthy soils and biodiversity.

Second, our native banana varieties will be displaced, and contaminated. These include Nedunendran, Zanzibar, Chengalikodan, Manjeri Nendran II


Table varieties
Monsmarie, Robusta, Grand Naine, Dwarf Cavendish, Chenkadali, Poovan, Palayankodan,Njalipoovan, Amritsagar, Grosmichel, Karpooravalli, Poomkalli, Koompillakannan, Chinali, Dudhsagar, Poovan, Red banana


Culinary varieties

Monthan, Batheea Kanchikela Nendrapadathy

Njalipoovan, Palayankodan, Robusta.



There is a perverse urge among the biotechnology brigade to declare war against biodiversity in its centre of origin. An attempt was made to introduce Bt brinjal into India which is the centre of diversity for Brinjal. GM corn is being introduced in Mexico, the centre of diversity of corn. The GM banana is being introduced to the two countries where banana is a significant crop and has large diversity. One is India, the other is Uganda, the only country where banana is a staple.

Fourth, as recognized by Harvest Plus, the corporate alliance pushing Biofortification, there could be insurmountable problems with the biofortification of nutrients in foods as they: “… may deliver toxic amounts of nutrients to an individual and also cause its associated side effects (and) the potential that the fortified products will still not be a solution to nutrient deficiencies amongst low income populations who may not be able to afford the new product and children who may not be able to consume adequate amounts.” (Food Biofortification: no answer to ill-health, starvation or malnutrition By Bob Phelpshttp://www.freshfruitportal.com/opinion-biofortification-is-an-obstacle-to-food-justice)


Fifth, Australian scientists are using a virus that infects the banana as a promoter. This could spread through horizontal gene transfer. All genetic engineering uses genes from bacteria and viruses. Independent studies have shown that there are health risks associated with GM foods.


There is no need for introducing a hazardous technology in a low iron food like bananas (which brings us many other health benefits )when we have so many affordable, accessible, safe and diverse options for meeting our nutritional needs of iron.


We have to grow nutrition by growing biodiversity, not industrially “fortify” nutritionally empty food at high cost, or put one or two nutrients into genetically engineered crops.


We don’t need these irresponsible experiments, that create new threats to biodiversity and our health, imposed by powerful men in distant places, who are totally ignorant of the biodiversity in our fields and thalis, and who never bear the consequences of their destructive power. We need to put food security in women’s hands so that the last woman and the last child can share in nature’s gifts of biodiversity.


#India- #Chhattsigarh pays Kareena Kapoor 1.40 crore, while 1 lakh children suffer malnutrition in the state

While over  over 1 lakh children are suffering malnutrition in Bastar,thE tribal region of chhattisgarh, while 80 prisoners including women are HIV positive in chhattisgarh, for more than a year Soni Sori a tribal teacher has been tortured, sexually assaulted, denied basic  HUMAN rights in chhattisgarh, and NCW says Soni Sori needs psychological counselling or she might die,  The Chhattisgarh government admitted on Thursday that it paid a whopping sum of Rs 1.40 crore to Bollywood actress Kareena Kapoor for her performance in November at the state’s anniversary function.


In a written reply to Congress member Mohammed Akbar in the state assembly, Public Works Department (PWD) Minister Brijmohan Agrawal, who holds the tourism and culture portfolios as well, said that 245 artistes performed during the weeklong (November 1-7) state foundation anniversary – Rajayotasava 2012- celebrations held in various districts and the government paid over Rs 5 crore to them.

The total expenditure as honorarium to 245 artistes, that included 42 artistes from outside the state, during Rajayotasava 2012 was Rs 5,21,22,500, the minister said. He also listed details of per person honorarium paid out by the government, with Kareena Kapoor topping the list at Rs 1,40,71,000. Kareena performed at main Rajayotasava venue at Naya Raipur on November 1 and her show was hardly for eight minutes.

The government also paid heavy amount to other artistes such as Sonu Nigam (Rs 36,50,000), Sunidhi Chauhan (Rs 32,00,000), Dia Mirza (Rs 25,00,000), Himesh Reshamia (Rs 24,00,000) and Pankaj Udhas (Rs 90,000).

The minister also informed the house that his department spent Rs 54,62,461 on inviting the artistes and their travel expenditure while the bill for artistes’ lodging and food was put at Rs 11,67,956.

#India-The right to food security #mustread

BMJ 2012; 345 doi: http://dx.doi.org/10.1136/bmj.e8273 (Published 10 December 2012)

Cite this as: BMJ 2012;345:e8273
  1. Veena Shatrugna, formerly deputy director, National Institute of Nutrition1,
  2. R Srivatsan, senior fellow2

Author Affiliations

  1. veenashatrugna@yahoo.com

Communities must push back against global policy decisions that fuel Third World hunger

The report from the Right to Food and Nutrition Watch published during October 2012 considered the effects of globalised food policies on populations in the Third World.1 It offered a very different perspective on food insecurity than that provided by official United Nations/World Bank documents. The authors of the report considered food security in light of social determinants of nutrition, such as food availability, agricultural policy, land transactions, cropping patterns, and agricultural finance. The report focused on the lack of accountability of large food producers that also own vast tracts of land to the people who face hunger and who have a right to food. Their damning indictment is that “the right to food of people around the planet has primacy over the need to fuel cars and economies in the European Union or North America.”

The report included a review of the progress of the Committee on World Food Security (an international body set up by the UN) after it was reformed in 2009 to include people’s organisations. The report stressed the importance of keeping the right to food as a benchmark in policy decisions. The World Trade Organization routinely takes major policy decisions that affect communities’ right to food without due consideration. Other offenders include international investment groups that negotiate the terms of bilateral trade agreements, public-private partnerships that promote directly delivered medicalised nutritional intervention, and those that engage in speculative trading in food. The report reviewed finance capital in agribusiness and outlined the devastating effects on poverty of speculative trading in food. Speculation on food prices has resulted in dangerously volatile food prices since 2007. Agribusiness trades through individual contracts and with little market transparency. The source of finance is surplus funds in the West, but speculation wreaks havoc and impoverishment in the Third World.

The report also presents several case studies that are eye openers to what happens on the ground. They illustrate, for example, how coercive land acquisition (grabbing)—a historical legacy of colonialism in the Arab Spring countries—and allocation of prime agricultural land to non-local industry cause food crises and impoverishment in agricultural communities. The increasing diversion of agricultural land away from food farming and to the cultivation of biofuels needed by Western countries is another major problem currently contributing to hunger in Africa. Widespread economic havoc has been caused in Mexico under the unfavourable North American Free Trade Agreement, which sees Mexico trading agricultural commodities with the United States.

India has had enormous growth in gross domestic product with no evidence of a trickle down effect. In 2006 it was estimated that 51.5% of Indian children were stunted and 54.9% were underweight. About 34.6% of adults reportedly had a body mass index of less than 18.5.2 It seems that there has been little recent change.

India’s long term food policies have resulted in an epidemic of stunting and decreased muscle mass in the children of poor families. Indian national policy has for decades emphasised cheap cereals as the major source of energy for its population. In a 1968 publication, nutrition experts suggested that a mixture of cheap foods like cereals, pulses, and vegetables could provide a mixture of amino acids that was very nearly as good as if animal proteins were consumed.3 This particular statement was reproduced in the 1971 edition of the Indian National Institute of Nutrition’s report Nutritive Value of Indian Foods and every reprint until the latest in 2011. Furthermore, it has influenced policies on food and wages, including the calculation and classification of the “poverty line.”

In 1970, people were regarded as being above the poverty line if they could afford to consume 10 042 kJ (2400 kcal) daily from the cheapest food source. Minimum wages were then calculated to provide this level of intake for a family of five on the assumption that they would consume cheap cereals. The famous “myth of protein gap,” based on an observation in 1971 that undernourished children (1670-2090 kJ daily deficit) could consume adequate protein (20 g/day) from cereal if only “they ate more of their usual foods,” changed the way the diets of poor adults and children were regarded.4 Promotion of a cereal-pulse vegetarian diet effectively removed animal proteins from Indian diets.3 Even consumption of pulses diminished over time. The more affluent vegetarians, a minority, consumed adequate daily protein requirements through sources such as milk and almonds.

In addition to widespread malnutrition and stunting, which underpins negative metabolic consequences in adulthood, more than 70% of women and children in India have anaemia and deficiencies in intakes of most vitamins and minerals.2Against this background of chronic poor nutrition, more food shortages have worsened malnutrition and hunger in the Indian population. A more recent concern in India, however, is the complex association between adult onset obesity and food insecurity. Accumulating evidence suggests that, although severe food insecurity leads to wasting, mild to moderate food insecurity is associated with obesity.5 This hunger induced morbidity pattern will continue to plague India for decades.

The Right to Food and Nutrition Watch 2012 report concludes by discussing how hungry people can regain control over those decisions that affect their food and nutritional situation. The authors highlight several successes, including the first international instrument that applied a human rights approach to agree on tenure of natural resources—the new Guidelines on Responsible Governance on Tenure of Land, Fisheries and Forests. These guidelines were adopted in May 2012 by the Committee on World Food Security after an inclusive and participatory process. They urge communities to occupy the newly created political spaces for inclusive decision making on food and nutrition.


Cite this as: BMJ 2012;345:e8273


  • Competing interests: Both authors have completed the ICMJE uniform disclosure form at www.icmje.org/coi_disclosure.pdf (available on request from the corresponding author) and declare: no support from any organisation for the submitted work; no financial relationships with any organisations that might have an interest in the submitted work in the previous three years; no other relationships or activities that could appear to have influenced the submitted work.

  • Provenance and peer review: Commissioned; not externally peer reviewed.


  1. Right to Food and Nutrition Watch. Who decides about global food and nutrition? Strategies to regain control. 2012. www.rtfn-watch.org/fileadmin/media/rtfn-watch.org/ENGLISH/pdf/Watch_2012/R_t_F_a_N_Watch_2012_eng_web_rz.pdf.
  2. National Nutrition Monitoring Bureau. Diet and nutritional status of population and prevalence of hypertension among adults in rural areas. Technical report 24. National Institute of Nutrition, 2006. www.nnmbindia.org/NNMBReport06Nov20.pdf.
  3. Gopalan C, Rama Sastri BV, Balasubramanian SC. Nutritive value of Indian foods. National Institute of Nutrition, 2011.
  4. Gopalan C, Narasinga Rao BS. Nutritional constraints on growth and development in current Indian dietaries. Indian J Med Res1971;59:111-22.
  5. Townsend MS, Peerson J, Love B, Achterberg C, Murphy SP. Food insecurity is positively related to overweight in women. J Nutr2001;131:1738-45.

Bombay High Court comes to the rescue of malnourished children

Malnourished child

Malnourished child (Photo credit: Wikipedia)


Activate MIS-based tracking, Maharashtra Government told

Soon children under six and mothers in Maharashtra’s Melghat region, which is facing malnutrition will be tracked using management information system (MIS) following a directive from the Bombay High Court in August.

“Steps should be taken by the State Government under the auspices of the Collector, Amravati, to activate the MIS-based tracking of children and mothers,” the Court said in its order in an ongoing case on malnutrition.

The Court directed that implementation begin on September 17, 2012. The Government should formulate short and long-term plans to tackle malnutrition, and devise a suitable plan setting out targets to be achieved expeditiously, the Court said.

The Melghat region, part of Vidarbha comprises Dharni and Chikhaldhara tehsils. On average, 400-500 children below six die every year in Melghat of various causes linked to malnutrition.

On an application made by petitioner Purnima Upadhyay on July 20, the Court noted that there was no information on any government website on the status of undernourished children and on infant and child mortality.

Statistics submitted to the Court show that as of June 2012 the number of children in the Moderately Acute Malnutrition (MAM) and Severely Acute Malnutrition (SAM) categories were 3,431 and 561, while children who are Moderately Under Weight (MUW) and Severely Under Weight (SUW) numbered 10,047 and 3,798.

Between April and June 2012 there were 81 child deaths (35 in Chikhaldhara and 46 in Dharni), 42 stillbirths and four cases of maternal mortality. Ms Upadhyay submitted that the figures for malnourished children seemed to remain at 14, 000 over the last two years and the number of SAM and MAM children did not show any remarkable decline.

The Court had to intervene also in providing emergency services in the Melghat region. The 22 emergency flying squads there had no vehicles this year until it ordered quick action in mid August. Even after that, Ms Upadhyay told The Hindu on Saturday, some primary health centres hired vehicles for a month and for the rest tenders had been invited.

The flying squads operate from May to October every year to cater to remote villages. This year, she said, over 100 villages were cut off due to heavy rain and there was no help for them in any form.

Since May the squads did not have vehicles, as a result of which the villagers in remote areas were placed at high risk especially in a medical emergency, the Court said.

The Court was informed that earlier tenders had been invited from private bidders for supply of vehicles at Rs.14,000 per vehicle per month. But no bids were available at that rate. The Collector chaired a meeting in June of the Navsanjivani Yojna and a decision was taken to invite fresh tenders. The government counsel told the Court that fresh tenders were invited, and 10 days allowed for submission of bids.

#NarendraModi attributes malnutrition partly to Gujaratis being largely vegetarian #WTFnews

by Venky Vembu Aug 29, 2012, First Post
 As Gujarat Chief Minister Narendra Modi prepares for the State Assembly elections later this year, which he will likely use to pitchfork himself as a candidate for Prime Ministership, he perhaps knows that his every move, his every word and his every deed is being subjected to clinical analysis.

Any misstep, any off-message rhetoric will doubtless be amplified by his political detractors – of whom he has more than a few – which is why he has been extraordinarily disciplined in his public pronouncements.

For the most part, having consolidated his hardcore Hindutva base, Modi has been focussing in recent times on reaching out to voters in the middle ground by emphasising his record of having advanced development in Gujarat.

Gujarat fares the worst in terms of overall hunger and nutrition among the industrial States. Reuters.

The State under Modi has built on the industrial base that it inherited from earlier times, and notched up impressive double-digit GDP growth that is doubly remarkable given Gujarat’s high growth base (unlike the case with, say, Bihar, which has a low growth base).

Yet, there is one puzzle about Gujarat, an area of very uncharacteristic underperformance for a rich State, which has befuddled even the keenest analytical minds. This relates to Gujarat’s low ranking, relative to even some vastly poorer States in India, on critical parameters that define human development. In particular, Gujarat fares the worst in terms of overall hunger and nutrition among the industrial States with a high per capita income.

On the face of it, this is counter-intuitive. Greater wealth should lead to better health and nourishment. But this theory fails in Gujarat’s case. Even Rural Development Minister Jairam Ramesh gave voice to his sense of puzzlement that high levels of malnutrition persist even in pockets of high economic growth.

There is, of course, a history to this grim statistic, which predates Modi’s term in office since 2001, which renders it somewhat difficult for Modi’s detractors to use it as a political stick to beat him with. If anything, nutritional and general health standards are improving under his watch. Yet, the larger puzzle of why the statistics should be so bad in the first place has not been cracked.

Modi himself makes bold to answer that question, in an interview to the Wall Street Journal today. The interview is part of a bio-profile of Modi, which frames his political ascendance against the backdrop of a dysfunctional UPA government that has run the economy to the ground. (You can read the bio-profile, headlined ‘In slowing India, a fast-growing star’, here.)

It is the latest in a line of instances of foreign media entities familiarising their readers about the man who, in their assessment, could, under certain circumstances, be India’s next Prime Minister. It also shows up a Modi who is making the effort to seem accessible, and is tailoring his message to reflect the interests of the publication.

Thus, for instance, in the interview to Wall Street Journal, Modi hits all the right business-friendly notes. “Government,” he says, “has no business to be in business.” The tragedy, he adds, is that there’s no liberalisation going on.

Modi’s criticism is, of course, directed at the UPA government, which has been paralysed for more than three years now – and has turned the clock back on economic reforms in their entirety, and set the stage for an even more aggressive encroachment by the state into the domain of business. (But it could well apply to the BJP too, given that the party hasn’t embraced any recorms either.)

So far, so good. But when the journal seeks out Modi’s response on Gujarat’s chronic malnutrition problem, his answers seem uncharacteristically outlandish.

Mr. Modi attributes malnutrition problems partly to Gujaratis being largely vegetarian and partly to body-image issues among young women. “The middle class is more beauty-conscious than health-conscious—that is a challenge,” he said. “If a mother tells her daughter to have milk, they’ll have a fight—she’ll tell her mother, ‘I won’t drink milk. I’ll get fat.’

This seems wrong on so many fronts. And Modi’s response effectively trivialises a very serious health and nutritional issue that shames Gujarat in particular (and India in general, given that the pan-Indian picture is also far from glowing).

The problem of malnutrition in Gujarat (and elsewhere) that comes through in official data represents a rather more serious failing than can be dismissed as the result of young Gujarati girls being acutely conscious of their curves.

The third National Family Health Survey, the latest available, shows that in Gujarat, as many as 41.4 percent of children under three years of age were underweight. And about half of Gujarati children under five were stunted. Children in those age groups may be a little too young to be “beauty-conscious” in the manner that Modi suggests. In fact, the statistics for Gujarat on this count are marginally worse than the national average, which is doubly astonishing considering that Gujarat is one of the higher-income States.

Likewise, some 55.3 percent of women in the 15-45 age group were anaemic in Gujarat, which is about the same for women across India.

Gujarat also comes across as faring worse than the national average, and even some of the poorer States, on some other indices of health and nutrition,

As the Human Development Report of 2011 noted, the hunger status measured by the Hunger Index for some industrial states and states with high per capita income, including Gujarat, is worse than some poor states. “This suggests that economic prosperity alone cannot reduce hunger. Hence, there is a need for specific target-oriented policies to improve the hunger and malnutrition situation. Inclusive economic growth and targeted strategies to ensure food sufficiency, reduce child mortality, and improve child nutrition are urgent priorities.”

Malnutrition, according to the report, reflects an imbalance of both macro- and micro-nutrients that may be due to inappropriate intake and/or inefficient biological utilization. Poor feeding practices during infancy and early childhood, resulting in malnutrition, could contribute to impaired cognitive and social development, poor school performance, and reduced productivity in later life.

Malnutrition, it added, is a major threat to social and economic development as it is among the most serious obstacles to attaining and maintaining the health of this important age group.

For all its record of industrial advancement and relative prosperity, Gujarat is seriously underperforming on the health and nutrition front, and the larger index of human development. On these counts, it comes across as faring worse than a Jharkhand or an Uttar Pradesh, which have much lower per-capita income. And although the roots of the health and nutrition crisis in Gujarat date back to a time well before Modi’s term in offfice, the fact that such inequities persist under more than a decade of his watch may prove to his Achilles heel, which his political opponents will doubtless seek to exploit.

For all his discipline in communicating the developmental message that he wants to put out, Modi may have done himself a disservice in suggesting that Gujarat’s sub-par performance on the health and nutrition front is accounted for by anorexic girls who are beauty-conscious in the extreme. Such pronouncements only leave him open to the charge that he is trivialising what is at its core a life-and-death issue for many Gujarati children.

Malnourished kids battle to stay alive in Maharshtra- Shining India ?

18-year-old Sarjubai Tota (lying behind the baby) weighs a mere 28 kg and was paralysed in the third month of her pregnancy. On May 20, she gave birth to a girl, who weighs 1 kg, without any medical assistance

, TNN | May 29, 2012,

SANGRAMPUR (BULDHANA): On May 20, 18-year-old Sarjubai Tota gave birth to a girl without any medical assistance in her thatched, one-room marital home. While Sarjubai weighs a mere 28 kg, her daughter weighs 1 kg (the normal weight for a newborn is around 2.5 kg).
Eight days on, Sarjubai hasn’t even held her daughter once. In fact, she is oblivious to her daughter’s presence. Paralysed in the third month of her pregnancy, Sarjubai now drifts in and out of consciousness and spends most of her time moaning in pain.

As shocking as Sarjubai’s situation is, this is the way of life for people in Shemba village where the Totas reside. The Sangrampur block, which includes Shemba village, of Buldhana district has emerged as the new Melghat with over 2,000 malnourished children and this year’s drought has only made things worse.

“I have to trek four km down a hill and then walk another six km to reach a shop from where I can buy milk. Water is a luxury and we get it if we are lucky. I don’t know how my wife and child will survive in these conditions,” said Sarjubai’s husband Santosh (20).

So scarce is water that the 400-odd people residing in Shemba village have to trudge down a rocky terrain for a kilometer to access the two nearest hand pumps. “Children suffer the most during a drought. While getting basic nourishment for them is a problem, they also have to run around for basic resources,” said an anganwadi teacher.

With inadequate healthcare facilities and anganwadis remaining shut for most of the summer months, villagers in the Sangrampur taluka watch helplessly as children wilt away due to malnutrition. Shemba alone has 40 malnourished children. Of the two anganwadis in the village, the one run by the zilla parishad is closed most of the time, said residents. The second, run by the Gajanan Maharaj Trust, is doing its bit by distributing food.

The Sangrampur taluka comprises 105 villages and has 3.25 lakh residents. Of these, 15,000 live below the poverty line. While the entire region is plagued by malnutrition, 18 tribal villages are worst hit.

In 2011, 23 child deaths were recorded in the taluka and activists claim this is a deflated figure. According to the data available with the child development care department, 18% or 2,567 children of the total 14,905 in the region suffer from moderate or severe malnutrition, which means they don’t weigh as much as they should in keeping with their age. Technically, 308 children suffer from moderate acute malnutrition and 28 from severe acute malnutrition (their weight does not correspond to height). This despite the fact that there are 173 anganwadis in the region to “cater to the needs” of the children.

Villagers and activists said they don’t remember a single primary healthcare worker visiting the region or balanced died being served to children in the recent past. “Although drought has been declared here, no efforts are being made to ease the situation. Critical patients have to be taken either to the government hospital in Akola which is 85 km away or Shegaon which is 60 km away,” said activist Kailash Khadse.

An integrated child development services official said, “We provide a balanced diet to children. Often, it is because people in these areas are uneducated that problems arise.”

“1000 steps” walk against Malnutrition, What an idea Sir ji ?

March 31, 2012, Kamayani Bali Mahabal

The Prime Minister  Manmohan Singh has recognized the harsh reality of malnutrition in India by saying “India‘s “unacceptably high” levels of child malnutrition are a “national shame”. Our State women and child welfare minister  Varsha Gaikwad  in the assembly’s winter session  last year in Nagpur  admitted on the floor of the house that only 68 children were dying daily in Maharashtra , and our State Health  Minister, Suresh Shetty walks “ 1000” steps against  Malnutrition. (http://articles.timesofindia.indiatimes.com/2012-03-25/mumbai/31236503_1_priya-dutt-tara-sharma-mothers)

Last Saturday, on March 24,  Mr Suresh Shetty with his vast  z- security , Page 3 celebrities and Bollywood stars , came together in their best dresses ,coming together after a hearty breakfast , at  the posh area of  South Mumbai, Nariman Point‘s NCPA complex ,  to  participate in the 1000 Steps walk  sponsored by Nestle and Times to India , to underline the importance of nutrition for mothers and their children, right from conception to the first two years of life.  One will  not find a soul on a Saturday mornings, except building  Guards.   The people who reached were the  Elite living around Nariman Point, Colaba, Marine Drive for a 1000 Steps Walk. But who were they walking for ? Were those people  there ? How absurd can you be, holding a march against malnutrition at Nariman point ?

A walk sponsored by Nestle, what am I missing here  ? Sponsoring what  Cerelac and  Lacotgen  for the participants ? Our Health Minister did not know that on March 19th , Delhi  Metropolitan Magistrate , after 17 years has charged Nestle India for violating the law (Infant Milk Substitutes Feeding Bottles, and Infant Foods (Regulation of Production, Supply and Distribution) Act.) in advertisements and labelling of its infant food products. Does our Health Minister know that  its important to enforce this law to protect mothers and children from the commercial influence.The Infant Milk Substitutes Act was brought in to regulate production, supply and distribution of infant milk substitutes, feeding bottles and infant foods to protect and promote breastfeeding and ensure the proper use of these food products.

Nestle through their products – Lactogen and Cerelac – had violated several sections of the Act by not printing the notice ‘mother’s milk is best for your baby’ in Hindi and also by not printing the warning that ‘Infant milk substitute or infant food is not the sole source of nourishment for an infant’ on the containers of Lactogen. The  warning was not printed in the size prescribed and all the mandatory information was not present in advertisements .

The march if at all ,  should have been  diverted to  Govandi, as same day same time there was a huge public meeting on the issue of Malnurtition co organsied by  Anna Adhikar Abhiyan, Anna Adhikar Abhiyan, Maharashtra, Tata Institute of Social Sciences, Jan Arogya Abhiyan,  there.   Govandi  where more than 75%  of  its population lives in slums and the  Human Development Index (HDI) is the lowest in the city, at a mere 0.2.  Healthcare is inadequate; the population per hospital is nearly 66,881. It has the highest infant mortality rate (IMR) in the city — nearly 66.47 deaths per thousand births, where Mumbai’s average is 40 per 1000 births.

Forty-five-thousand children die of malnutrition every year in the state, according to ‘A report on nutritional crisis in Maharashtra’ by the Pune-based organisation Sathi-Cehat. One-third of adults are underweight, and 15% severely underweight. The report points out that chronic hunger is not confined to rural areas, as is popularly believed; urban populations in coastal regions, including the city of Mumbai, have the highest prevalence of calorie deficiency (43%) in the state. Calculations made using the per-consumer-unit-calories norm of 2,400 in rural areas and 2,100 in urban areas reveals that the incidence of calories-based poverty is 54% in rural areas and 39.5% in urban areas

The Maharashtra government had planned to bring down the number of malnourished children in the state by providing them with packaged food. The idea might have been noble but the government, it seems, forgot to run quality checks. As a result, the food supplied is substandard and the number of children dying of malnutrition has gone up substantially.  The State government statistics peg the number of children (0-6 years age group) who died of malnutrition between January and August  2011  as  18,486. The figure for the same period in 2010 was 12,792. So, this means 5,694 more babies diedLst  year.

 Investment  Rs 300 crore were spent in Maharashtra  for Take homes Ration ( THS ) scheme and the Returns-40% of children in Mumbai with low birth-weight.

Take Home Ration (THR) scheme has been a failure. Health workers mostly pay out of their pockets to clear unused THR. The food packets supplied as THR (Take Home Ration) are devoid of any nutrition and taste. Children and parents are reluctant to take these raw food items home, as they are made of low-grade ingredients, which get spoilt in a short period of time. Last month these packets were thrown by people  in garbage after finding fungi and termites in them.

THR scheme is way short in calories, also children between six months and three years can barely accept the food: sheera, upma, sattu and sukhdi (meant for adolescent girls). Of the four, sheera is the most important as it is recommended for and given to severely malnourished children at least thrice daily. In one of the series on malnutrition it was reported by DNA ” A nutritional analysis test  on the food provided by Anacon Laboratories Pvt Ltd, Nagpur, showed 3g of protein and 42 calories less (sample size was 100g) than the amount mentioned on the packets. Upma and sukhdi had 75 and 70 calories less.”

So, instead of  walking “1000 steps”,  Mr Suresh Shetty you should provide home cooked food to children between age of 0 -6 in Angawadis,  Disband the THR Scheme and  Implement the ICDS scheme for children, in true letter and spirit.  and I hope next time  , MP Priya Dutt  and Bollywood stars like  Amole Gupte ,  Konkona Sen Sharma and  Tara Sharma , when accept any invitation on a cause  I hope they reach out to the People affected, rather  than  a  mere tokenism , So how does this idea sound Sir ji ?

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