Rapid economic growth is not reducing under-nutrition among Indian children, research by public health experts at Harvard and the University of Michigan has found, challenging perceptions that the country’s 9% growth will kill its scourge of malnutrition.
Led by Delhi-born Harvard School of Public Health researcher SV Subramanian, the team’s research found no evidence that high growth states were performing better than low growth counterparts in tackling child under-nutrition.
Their findings – based on data of 77, 326 Indian children collected by National Family Health Surveys (NFHS) in 1992-93, 1998-99 and 2005-06 -- have been published in the latest edition of the journal Public Library of Sciences (PLOS). "Our findings show that relying on economic growth alone to tackle under-nutrition -- the dominant policy approach in India – will not help," Subramanian told HT.
Repeated reports by global agencies and researchers have shown India’s nutritional standards below many sub-Saharan African countries, which have not witnessed the economic boon India has seen over recent years.
But the research by Subramanian and his team is the first to study the relationship between economic growth and child under-nutrition within a country.
The only previous known research that studied relations between economic growth and child nutrition studied data from 63 countries and found that children were at lower risk of under-nutrition in countries with high growth. That study was an ecological analysis, used data from 1970-96. Ecological studies assume that the risk of under-nutrition is the same for all children in a state. The new research by Subramanian and his team is a multilevel study in contrast.
The team of researchers consisted of Ichiro Kawachi from the Harvard School of Public Health, Lisa Berkman from the Harvard Center for Population and Development Studies and Malavika Subramanyam from the University of Michigan, Ann Arbor apart from Subramanian.
"The absence of proper access and nutritional education are the biggest factors behind high growth not resulting in reduced under-nutrition in India,” Dr. Raghunatha Rao, assistant director of India’s apex nutrition institute, the Hyderabad-based National Institute of Nutrition, told HT. Rao is unassociated with the research.
The researchers used the World Health Organization (WHO) Child Growth Standards to classify children either as undernourished or not. They used per capita net state domestic product (SDP) as a measure of a state’s economic development. This data was obtained from the Reserve Bank of India for all states for the years 1993, 1998 and 2005 and measured in 2008 rupees.
To take into account new states created during this period, the researchers calculated the average of the per capita SDP of the parent state and the new state and used it for comparative analysis of the parent state’s performance before and after the creation of the new states.
“While our study looked at different states to conclude the absence of correlation between economic growth and under-nutrition in India, the data also gave us a pan-India picture that suggests investing in direct medical and nourishment programmes may be a worthwhile strategy,” said Subramanian, clarifying that the research published in the PLOS yesterday did not address the specific question of whether nutritional interventions have helped tackle under-nutrition among Indian children.
The absence of education and access were plaguing nutrition in India in a manner similar to the problems afflicting the public distribution system, Rao said. Nutritional education at the community is completely lacking, even among the highly educated in India, Rao said.
“Look at the IT sector for instance. You have very well educated youth who work in front of computers hours at a stretch, and at the end of office, grab a pizza, hamburger or cold coffee – without thinking about its nutritional implications considering their already stressful work schedules,” the NIN scientist said.
The absence of nutritional education is a problem even in rural India, Rao argued. Vegetables – in abundance in large parts of rural India especially during the monsoon season – are not consumed adequately because of the absence of nutritional education, he said.