Malnutrition and stunting is higher in the country than the poorest parts of sub-Saharan Africa and here's why - infections, mostly waterborne such as diarrhoea, affect far more children in India, leaving them weak and stunted.
"Rural poverty is higher than India in most parts of Africa, but children in the country are shorter and more underweight because their bodies use up all energy to fight frequent infections, lowering their strength and growth," said Aidan Cronin, Child's environment Programme, UNICEF.
Unsafe water and poor sanitation are the biggest causes of infection. "Half of India uses open defecation, as compared to 4% in neighbouring Bangladesh. The faeces - one and a half stadia full each day - contaminates food and water, causing frequent infections," says Cronin.
In the country, 43% of children below 5 years are underweight (54 million) and 48% (61 million) are stunted because of undernutrition.
Despite a sizeable water resource base, unequal distribution, unregulated groundwater extraction, water pollution and deteriorating quality because of poor sanitation and bad waste management, India struggles o meet its water sector requirements, says UNICEF and Food and Agriculture Organisation (FAO)'s Water in India: Situation and Prospects, the first cross-sectoral assessment of the state of water resources in India, which was released on Thursday.
Only one in 10 (11%) rural homes and 48% urban homes has tap water. Less than a third of the 38,000 million litres of sewage generated each day is treated, as capacity exists for threatening only about 12,000 million litres per day.
Capacity does not mean actual treatment or its quality, with 39% of sewage treatment plants not even conforming to the standards of the country's Environment (Protection) Rules).
Death and disease apart, inadequate sanitation also causes economic losses equivalent to 6.4% of the country's GDP (US$53.8) - the state income of Tamil Nadu -- most of which can be prevented with improved water management.
As many as 43 of the country's 88 industrial clusters are critically polluted, while another three are severely polluted, according to the Central Pollution Control Board. Added to that, water safety is threatened by natural contamination, such as salinity (Rajasthan, Kerala, Karnataka), iron (Assam, Bihar, Chattisgarg), nitrate (Karnataka, Rajasthan, Maharashtra), fluoride (Rajasthan, Karnataka, Bihar) and arsenic (Assam, West Bengal, Bihar).
Water demands is far exceeding supply and leading to inter-sectoral conflicts between domestic, agricultural and industrial use. "Since water is used for multiple purposes, involving potential users in its management is essential to resolve conflicting demands and make access and supply sustainable,' says Satya Priya, national programme coordinator (land and water), FAO.