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Hunger / HDI | Malnutrition
Malnutrition

Malnutrition

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What's Inside

 

 

According to The State of Food Insecurity in the World Report 2009: Economic Crises-Impacts and Lessons Learnt, http://www.fao.org/docrep/012/i0876e/i0876e00.htm: 

• In the case of India, proportion of undernourished in the total population has increased from 21% in 2000-02 to 22% in 2004-06. The number of undernourished people in India has increased from 223.0 million in 2000-02 to 251.5 million in 2004-06.

• The economic turmoil sweeping the globe has led to a sharp spike in hunger affecting the world’s poorest, uncovering a fragile global food system requiring urgent reform. The combination of the food and economic crises have pushed more people into hunger, with the number of hungry expected to top 1 billion this year

• The World Food Summit target of reducing the number of undernourished people by half to no more than 420 million by 2015 will not be reached if the trends that prevailed before those crises continue.

• Strides in improving access to food were made in the 1980s and early 1990s, thanks to stepped up agricultural investment after the global food crisis of the early 1970s. However, official development assistance (ODA) fell between 1995-1997 and 2004-2006, resulting in surges in the number of undernourished in most regions.

• The increase in the number of the world’s hungry in times of both low prices and economic prosperity as well as periods of price spikes and recessions shows how weak the global food security governance system is

• Even before the consecutive food and economic crises, the number of undernourished people in the world had been increasing slowly but steadily for a decade. The most recent FAO undernourishment data covering all countries in the world show that this trend continued into 2004–06.

• The number of hungry people increased between 1995–97 and 2004–06 in all regions except Latin America and the Caribbean. Even in this region, however, the downward trend was reversed because of the food and economic crises. While the proportion of undernourished continually declined from 1990–92 to 2004–06, the decline was much slower than the pace needed to meet the hungerreduction target of the first Millennium Development Goal (MDG).

• The current economic crisis emerged immediately following the food and fuel crisis of 2006–08. While food commodity prices in world markets declined substantially in the wake of the financial crisis, they remained high by recent historical standards. Also, food prices in domestic markets came down more slowly, partly because the US dollar, in which most imports are priced, continued to appreciate for some time, but also, more importantly, because of lags in price transmission from world markets to domestic markets. At the end of 2008, domestic prices for staple foods remained, on average, 17 percent higher in real terms than two years earlier. This represented a considerable reduction in the effective purchasing power of poor consumers, who spend a substantial share of their income (often 40 percent) on staple foods.

• The number of undernourished in the world will have risen to 1.02 billion people during 2009, even though international food commodity prices have declined from their earlier peaks. If these projections are realized, this will represent the highest level of chronically hungry people since 1970.

• During the 1990s and the current decade, however, the number of undernourished has risen, despite the benefit of slower population growth, and the proportion of undernourished increased in 2008.

• Because the world energy market is so much larger than the world grain market, grain prices may be determined by oil prices in the energy market as opposed to being determined by grain supply.

• Although domestic prices for most countries declined somewhat during the second half of 2008, in the vast majority of cases, and in all regions, their decline did not keep pace with that of international food commodity prices. At the end of 2008, domestic staple food prices were still 17 percent higher in real terms than two years earlier, and this was true across a range of important foodstuffs.

• India will be less affected than many other Asian countries because its cautious financial policies have reduced the country’s exposure to external financial shocks. In addition, continuing government support to the agriculture sector has transformed India from a net importer of grains to a net exporter.

• Investing in agriculture in developing countries is key as a healthy agricultural sector is essential not only to overcome hunger and poverty, but also to ensure overall economic growth and peace and stability in the world.

 

According to the Nutritional Intake in India: 2004-2005, NSS 61st Round, July 2004- June 2005:

 

 The consumer expenditure survey shows that the percentage share of food expenditure in total expenditure by Indian population was 55.0% in the rural areas and 42.5% in the urban areas. Relative to the comparable survey results for 1993-94, the share of food expenditure has dropped by 8.2 and 12.2 percentage points in rural and urban areas, respectively.

 Average daily intake of calories by rural population has dropped by 106 kcal (4.9 percent) from 2153 kcal to 2047 Kcal from 1993-94 to 2004-05 and by 51 Kcal (2.5 percent) from 2071 to 2020 Kcal in the urban area.

 Population reporting a calorie intake level of “less than 100%” of the norm of 2700 kcal, formed 66 percent of the total in rural areas and 70 percent of the total in urban areas.

 Some states at the higher end of the average intake of calorie per consumer unit per diem were Punjab (2763), Uttar Pradesh (2743) and Rajasthan (2714) in the rural areas and Jharkhand (3013), Bihar (2683) and Punjab (2614) in the urban areas. On the other hand, Karnataka (2276) and Tamil Nadu (2294) in the rural areas and Maharashtra (2261), Karnataka (2385) and Tamil Nadu (2394) in the urban areas were found to have much lower intake of calorie than the Indian average. In terms of per capita calorie intake, Assam, Bihar, Haryana, Punjub, Rajasthan, West Bengal and Uttar Pradesh were higher than the national average of 2047 Kcal.

 In the rural areas, the people of Orissa (79%), Chhatisgarh (78%) and Jharkhand (75%) reportedly derived around 75% of actual intake of calorie from cereals.  On the other hand, people of Punjab (50%), Haryana (54%) and Kerala (54%) reported a smaller percentage of calorie intake from cereals

 Average daily intake of protein by the Indian population has decreased from 60.2 to 57 grams in the rural area between 1993-94 and 2004-05 and remained stable around 57 grams in the urban area during the same period. 

 While the intake of calorie was observed to be lower, the level of protein and fat consumption was considerably higher than the standard minimum requirement per diem per consumer unit in both the sectors.  A higher intake of calorie and protein was observed in the rural India (2540 kcal and 70.8 gms.) as compared to urban India (2475 kcal & 69.9 gms.) whereas, the consumption of fat was relatively much lower in rural areas (44.0 gms.) compared to that in urban areas (58.2 gms.).

 A significant rise in per capita daily average intake of fat is observed during the decades (1993-94 to2004-05) in both rural and urban areas. It has increased from 31.4 gms. to 35.5 gms. (13.1 percent) in rural areas and from 42 gms. to 47.5 gms. (13 percent) in urban areas.

 At national level, the number of meals taken at home had decreased by 0.57%, major states having undergone similar declines were Karnataka (-13.0%), Gujarat (-75%), Andhra Pradesh (-7.37%) whereas in West Bengal it remained unchanged in the rural India. In the urban India, prevalence of home-cooked meals had gone down by 1.66% over last eleven years. The leading contributors were Karnataka (-13.2%), Andhra Pradesh (-9.35%), Assam (-8.56%) whereas the it had increased for states like Haryana (8.81%), Gujarat (1.46%) and West Bengal (0.42%).

 At the national level, the number of meals eaten at home by household members had decreased by 0.57% in the rural areas between 1993-94 and 2004-05. In urban India popularity of home kitchen had declined by 1.66% over last ten years. 

 Meals taken outside home were mainly concentrated among the age group 5-9 and 10-14 years for both the sex in all the sectors. Among the meals taken outside home in these age groups, most were from schools or Balwadi, might be in the form of ‘Mid-day Meals’. Both in rural and urban area, meals taken on payment were a rare phenomenon. 

Notes

Consumer unit:  Consumer unit is the rate of equivalence of a normal person determined on the basis of age-sex composition  of a person. It is usual to assess the calorie needs of men, women and children in terms of those of the average man by applying various coefficients to the different age-sex groups. Consumer unit of  a normal male person doing sedentary work and belonging to the age group 20-39 is taken as one unit and the other coefficients are worked out on the basis of calorie requirements. Alternatively consumer unit is a normative rate of equivalence of a given age-sex specific person in relation to a ‘standard’ male person aged 20-39 years and doing sedentary work who is taken to be equivalent to one consumer unit. Nutritionists, attempting to assess calorie requirements per consumer unit, differ in their approaches to the problem, some specifying calorie requirement as function of body weight, while others assign requirements depending on nature of work (sedentary/moderate/heavy). From  the 26th round, the NSS has been using a level to the tune of 2700 calories per consumer unit per day as a standard and measure of actual intake may be compared with it.  This level (2700 calories per consumer unit per day) is referred to & reported as the "norm" level of calorie intake.
 
Monthly per capita consumer expenditure (MPCE):  For a household, this is the total consumer expenditure over all items divided by its size and expressed on a per month (30 days) basis. A person’s MPCE is understood as that of the household to which he or she belongs.

 

According to the World Bank:
http://web.worldbank.org/WBSITE/EXTERNAL/NEWS/0,,contentMD
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• The prevalence of underweight children in India is among the highest in the world, and is nearly double that of Sub-Saharan Africa, the report says.. It also observes that malnutrition in India is a concentrated phenomenon. A relatively small number of states, districts, and villages account for a large share of the burden - 5 states and 50 percent of villages account for about 80 percent of the malnutrition cases.

• Reductions in the prevalence of malnutrition over the last decade have been small – the prevalence of underweight has only fallen from 53 percent to 47 percent between 1992/93 and 1998/99

• More than 75 percent of preschool children suffer from iron deficiency anemia (IDA) and 57 percent of preschool children have sub-clinical Vitamin A deficiency (VAD).  Iodine deficiency is endemic in 85 percent of districts.
 
• Child malnutrition is a leading cause of child and adult morbidity, mortality, and cognitive and motor development. Malnutrition is estimated to play a role in about 50 percent of all child deaths, and more than half of child deaths from malaria (57 percent), diarrhea (61 percent) and pneumonia (52 percent). Overall, child malnutrition is a risk factor for 22.4 percent of India’s total burden of disease.

• In India, child malnutrition is responsible for 22 percent of the country’s burden of disease. Undernutrition also affects cognitive and motor development and undermines educational attainment; and, ultimately impacts on productivity at work and at home, with adverse implications for income and economic growth. Micronutrient deficiencies alone may cost India US$2.5 billion annually.
 
•  In India, child malnutrition is mostly the result of high levels of exposure to infection and inappropriate infant and young child feeding and caring practices, and has its origins almost entirely during the first two to three years of life. However, the commonly held assumption is that food insecurity is the primary or even sole cause of malnutrition. Consequently, the existing response to malnutrition in India has been skewed towards food-based interventions and has placed little emphasis on schemes addressing the other determinants of malnutrition.

• States with the highest levels of malnutrition have the lowest levels of ICDS program funding and a smaller percentage of their villages covered by ICDS centers than states with less malnutrition - The five states with the highest underweight prevalence, namely Rajasthan, Uttar Pradesh, Bihar, Orissa and Madhya Pradesh, all rank in the bottom ten in terms of ICDS coverage

• Underweight prevalence during NFHS-II was higher in rural areas (50 percent) than in urban areas (38 percent); higher among girls (48.9 percent) than among boys (45.5 percent); higher among scheduled castes (53.2 percent) and scheduled tribes (56.2 percent) than among other castes (44.1 percent); and, although underweight is pervasive throughout the wealth distribution, the prevalence of underweight reaches as high as 60 percent in the lowest wealth quintile. Moreover, during the 1990s, urban-rural, inter-caste, male-female and inter-quintile inequalities in nutritional status widened.

 

According to the National Family Health Survey-III (2005-06), http://www.nfhsindia.org:


• Percentage of children (under 3 years) who are stunted declined from 45.5 during NFHS-II (1998-99) to 38.4 during NFHS-III at the all-India level. The prevalence of stuntedness (during NFHS-III) among children below 3 years was highest in Uttar Pradesh (46.0%), to be followed by Chattisgarh (45.4%) and Gujarat (42.4%).

• Percentage of children (under 3 years) who are wasted increased from 15.5 during NFHS-II to 19.1 during NFHS-III at the all-India level. The prevalence of wastedness (during NFHS-III) among children below 3 years was highest in Madhya Pradesh (33.3%), to be followed by Jharkhand (31.1%), Meghalaya (28.2%) and Bihar (27.7%).  

• Percentage of children (under 3 years) who are underweight declined meagerly from 47.0 during NFHS-II to 45.9 during NFHS-III at the all-India level. The prevalence of underweightedness (during NFHS-III) among children below 3 years was highest in Madhya Pradesh (60.3%), to be followed by Jharkhand (59.2%), Bihar (58.4%), Gujarat (47.4%) and Uttar Pradesh (47.3%). 

 

Life cycle approach to inter-generational malnutrition

life cycle nutrition

Source: ncbi.nlm.nih.gov  

 


According to Facilitating Improved Nutrition for Pregnant and Lactating Women, and Children 0–5 Years of Age by Kathryn G. Dewey (2003), PhD, University of California, Davis, USA, http://www.enfant-encyclopedie.com/Pages/PDF/DeweyANGxp.pdf:
 

* Nutrition during childhood and adolescence influence a woman’s pre-conceptional nutritional status, which subsequently influences the outcome of pregnancy and the health of her child. Malnutrition is perpetuated across generations via this cycle. For this reason, programs to improve the nutrition of women and children must be comprehensive, targeting all stages of the life cycle.

* Why are maternal and child nutrition important in the context of early childhood development? There are numerous linkages between adequate prenatal and postnatal nutrition and a child’s physical, cognitive, emotional, and motor development. For example, low birthweight resulting from intrauterine malnutrition is a key predictor of developmental delay, among other adverse outcomes. Duration of breastfeeding has been positively associated with a child’s cognitive and motor development. Maternal nutritional status, such as iron-deficiency anaemia, may affect the degree and quality of child caregiving. Lastly, maternal dietary practices and weight status are strongly related to a child’s risk of being overweight, a condition that can have lasting consequences on emotional and physical development.

* Ensuring adequate diets prior to pregnancy, during pregnancy and lactation, and during early childhood (particularly the first two years) is essential. Such interventions have the potential to substantially enhance child development, as well as the general health of women and children.

Rural Expert

Tagged with: Malnutrition



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