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Resource centre on India's rural distress
 
 

Indian children still underweight – after 20 years of interventions by Jason Burke

Inefficiency, the global financial meltdown and rising food prices have conspired to reverse progress made on poverty and hunger

Head out of Delhi, across the fetid Yamuna river, with the tourist sites behind you and the northern Indian plains in front of you. Go past the new, luxury flats built for the Commonwealth Games, turn right and follow the lines of the new metro and then plunge left, avoiding the chaotic traffic and the occasional bullock cart and into the seething slums.

In a small, two-roomed flat off one of the packed streets of Kalyan Puri, one of the biggest slum neighbourhoods, you will find Anju Rao, a 50-year-old grandmother who spends her days looking after her two small grandchildren. Their parents are rickshaw pedallers and construction workers and only return home after dusk, if at all.

"It's not so bad. Everyone in the family has got used to it," Rao says, looking out through the lattice of illegal electricity wires at the drenching monsoon rain.

On every street corner of this district, at around noon, a woman with a big tin pot ladles out thick gruel to a stream of small children carrying tin bowls. Each one is meant to get exactly 320 grammes, but few are measuring what ends up in their bowls. Each of these feeding points, known as anganwadi, which means "courtyard shelter" in Hindi, looks after between 100 and 200 children and their mothers.

It is among the world's biggest organised feeding schemes for young children, which according to government estimates reaches 58 million children. It is one of many programmes introduced by successive Indian governments aimed at curbing malnutrition in adults and, especially, in children. Yet, despite the investment of billions each year and initiatives ranging from employment guarantee schemes to school meals, malnutrition in India is rife and the country is almost certain to miss the millennium development goal one – eradicating extreme poverty and hunger – by 2015 by a considerable margin. This is despite economic growth that has more than quadrupled India's per capita gross domestic product since 1992.

"Growth has seen the poor get poorer," says Dunu Roy, of Hazards Centre, an independent thinktank in Delhi. Calculating poverty in India, as elsewhere, is a fraught business. By the government's calculations, poverty has been dropping steadily in recent years. Whatever the trend, a recent study by researchers at Oxford University revealed how grave problems still are. Using innovative methodology, factoring a range of elements from cooking fuel used to simple food intake, researchers found that there were more poor in the eight poorest states of India – 410 million people – than in the 26 poorest nations of Africa. Levels of poverty in the central Indian state of Madhya Pradesh, for example, were roughly comparable with those in the Democratic Republic of the Congo.

One reason for the persistence of malnutrition in India is that the myriad schemes set up to combat it are hugely inefficient. The largest involve the distribution of subsidised food to the needy. The subsidies are significant. Rampant food inflation over recent years now means that a kilo of wheat costs around 15 rupees (11p) and of rice, 25 rupees (18p).

But that means incentives for corruption are high. Corruption on the part of both food distributors and officials, combined with administrative incapacity and poor logistics all impede delivery. This summer, a row blew up in the Indian parliament amid claims that the entirely predictable monsoon rains destroyed around £8bn of food because of poor storage. "We estimate that around half the food actually gets distributed," says Roy.

In its last MDG interim report, the UN also identified the food crisis of 2007 and the financial chaods of the same year as contributory factors in India and other countries' continuing poor record in this area.

"Before the onset of the food and financial crises, a number of regions were well on their way to halving, by 2015, the proportion of their population that were undernourished. South-eastern Asia, which was already close to the target in 2005-2007 made additional progress, as did Latin America and the Caribbean and Eastern Asia. Progress in the latter region was largely due to reductions in hunger in China. The prevalence of hunger also declined in sub-Saharan Africa, although not at a pace that was suffi ciently fast to compensate for population growth and to put the region on track to meet the MDG target."

The world still has a long way to go to meeting MDG1; the prevalence of underweight children worldwide fell from 31% in 1990 to 26% in 2008, according to a Unicef report published this month. And the progress that is being made is not necessarily helping the worst-affected.

"In India… there was no meaningful improvement among children in the poorest households, while underweight prevalence in the richest 20% of households decreased by about a third between 1990 and 2008," the report said.

In Kalyan Puri, around half of the local distribution offices were shut and the officials paid to weigh children and monitor distribution absent. Many locals in the slum turn to Nurmila, a 31-year-old local NGO worker, who is employed under a separate Delhi state government scheme which aims to try to improve locals' access to services. "Very few of the families with ration cards actually get their rations. The shops are never open or they just don't hand over the right amount," says Nurmila. "Some families go for months without the food the government says they should get."

Those that do get the rations often complain that the better-quality wheat purchased by the government is often replaced with a poor substitute by the shop owners. As for the food doled out on the doorsteps by the anganwadi, many complain it is often inedible.

It is also, being largely rice, pulses or wheat porridge, unsuited for very young infants. The real problem in India, experts say, is undernourishment of the very young. Children of five and above receive – at least theoretically – their midday meal at school. In Kalyan Puri, new-borns and toddlers fall through a gap in provision. Yet these years are crucial for later mental and physical development.

According to the World Bank, 43% of Indian children are underweight – the highest level in the world and a figure that has remained constant for at least 20 years. In China, the figure is only

7%, in sub-saharan Africa it averages 28%. Poor nutrition among lactating and pregnant mothers means the effects of post-natal malnutrition for children are exacerbated.

The results are evident in the charity-run primary school run for street kids behind the police station. Here, teacher Amitha Joshi says many children do not eat from early in the morning when their parents leave home until late at night. "They cannot concentrate, cannot retain any facts, they have serious behavioural problems," she told the Guardian.