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Karnataka: malnutrition deaths despite high growth

Karnataka, India’s IT success story and its most preferred destination for foreign investment, boasts of the country’s highest per capita income. Its economic indicators are nothing short of superlative and yet the South Indian State accounts for thousands of child deaths due to malnutrition. A recent report shows that despite high SGDP growth and heightened economic activity, Karnataka fares poorly in hunger index and child malnutrition.

A recent report by news channel (TV9) showing a severely malnourished 5-year-old boy Anjeneya and his subsequent death has drawn the State’s attention to the miseries of child malnutrition in Raichur district and Karnataka as a whole.

The incident finds mention in a damning report by Clifton D’ Rozario, Advisor to Commissioners of the Supreme Court in the case “PUCL vs UoI & Ors. (W.P. No. 196 of 2001)”, commonly known as Right to Food case. (Link)

The report states that since April 2009 to August 2011, 2689 malnourished children have died in the district of Raichur alone, and 4531 children are suffering from severe malnutrition. Government functionaries, including Chief Minister Sadananda Gowda have admitted this. Attributing it squarely on the apathy of government, the Advisor said he has repeatedly drawn the attention of the authorities and the State Government to the grave situation in Raichur district.

As per the official statistics acquired through the Right to Information, the details of deaths of malnourished children are as follows:

Table Malnutrition
Observing that childhood malnutrition violates several core human rights commitments at the international level as well as Constitutional commitments, the Advisor says that the response of the Government of Karnataka has been inadequate and deeply unmindful of the nature of its own constitutional obligations. “Though on paper there are schemes for malnourished children, it does not appear to be adequate or translate into action,” the report says.

Citing some of the key problems that prevent child malnutrition from being eliminated, the report lists poor quality of food at the top. “There appears to be widespread consensus that it is unpalatable by the children, parents and anganwadi teachers, and further that it is not nutritious,” the report says.

A major problem lies in the identification of children who are suffering from malnutrition, a task assigned to the Anganwadi Teacher who has to forward a list of such children to the Supervisor for further action. The Advisor’s report points out problems at every stage there are no proper weighing machines or scales in every anganwadi nor is it done every month for every child; reports are not prepared properly; the Supervisor does not take suitable action on them; the provisions for providing proper care, medicines and nutrition to identified children are implemented only a handful of cases.

The Advisor observes “that the vast majority of children suffering from severe malnutrition belonged to the SC community”, particularly to the Madiga sub caste. “It can also be seen from the visits conducted that the children affected were disproportionately female,” he adds.

As for health care, the Advisor says, “The implementation of the NRHM (National Rural Health Mission) has been half-hearted and there are several instances of corruption in the matter.” Nurses and doctors do not visit hospitals regularly and do not take much interest.

The Advisor recommends a host of steps to fill the gaps in the system. He backs a suggestion that community based nutrition centres should be started in villages with severely malnourished children, possibly in the anganwadis itself. For this, the government should consider setting up Nutrition Rehabilitation Centres (NRC), linked to the Community Health Centres or District Hospitals. It has also suggested no child should be denied admission to NRCs.

The report cites the NFHS-3 data that paints a rather dismal picture of Karnataka in regard to the health and nutrition status of children.

•    The infant mortality rate in Karnataka is estimated at 43 deaths before the age of one year per 1,000 live births. The under-five mortality rate is 55 deaths per 1,000 live births.
•    Infant mortality in rural areas (47) is 28 percent higher than in urban areas (37).
•    The Government of India recommends that children under three years receive vitamin A supplements every six months, starting at age 9 months. However, only 23 percent of last-born children age 12-35 months were given a vitamin A supplement in the past six months, and only 53 percent of children age 6-35 months ate vitamin A-rich foods during the day or night.

Children’s nutritional status as indicated by physical development:
•    44% of children under age five are stunted, or too short for their age.
•    18% of children are wasted, or too thin for their height.
•    38% are underweight.
•    Children in rural areas are more likely to be undernourished; but even in urban areas, more than one-third of children under age five years suffer from chronic under nutrition.
•    70% of children between the ages of 6 and 59 months are anaemic.
•    More than half of women in Karnataka (52%) have anaemia. 63% of pregnant women are anaemic.
•    Anaemia is much more widespread among children age 6-35 months than it was seven years ago at the time of NFHS-2.

 
Further readings:

Child Malnutrition in Karnatakaby Adv. Clifton D’ Rozario (2011),

http://www.altlawforum.org/legal-advocacy/malnutrition-in-
karnataka/Malnutrition%20Report.pdf/at_download/file

Child Malnutrition in Karnataka-A Report by LawrenceLiang, 24 October, 2011,

http://kafila.org/2011/10/24/child-malnutrition-in-karnata
ka-a-report/

Child malnutrition: Myths andsolutions- A.K. Shiva Kumar

http://www.littlemag.com/hunger/shiv.html

The Child Malnutrition Myth-Whydoes nobody question the absurdly high numbers cited for India?- ArvindPanagariya, The Times of India, 1 October, 2011,

http://articles.timesofindia.indiatimes.com/2011-10-01/edi
t-page/30230007_1_underweight-children-maternal-mortality-
mortality-rate

Karnataka HDR 2005, http://www.im4change.org/state-report/karnataka/12

Malnourishment: children of SC, ST families worst-hit, The Hindu, 24 November, 2011, http://www.thehindu.com/todays-paper/tp-national/article26
54794.ece