India's big empty
Malnutrition must be seen as a national emergency. Manoj Kumar writes.india Updated: Nov 11, 2011 22:53 IST
Over the last few years, a group of us, including young parliamentarians, have been touring India's hinterland, visiting anganwadis, households, government officials and even political leaders to learn, assess, engage and create a consensus that eliminating malnutrition will be the next big thing to accomplish as a nation.
India's Integrated Child Development Services (ICDS) is the world's largest national programme that addresses the health and nutrition needs of those under the age of six. To many, it may seem that the challenge lies in implementing a big scheme in an effective manner.
But the reality is far more daunting than it appears; two big macro-level challenges confront us. First, malnutrition, which unlike say HIV/Aids or malaria, is not a virus-borne disease and, therefore, no amount of research to isolate the enemy works. By now it is well established that just food or feeding will not solve the problem.
Second, the complexity and multiplicity of the reasons behind malnutrition and very slow success rates point to the fact that the enemy is within us. Poverty, lack of scientific temperament, gender disparities, the marginalised role of mothers, the lack of coordination among government departments (sanitation, rural development, woman and child welfare, drinking water) are all factors that both the political class and civil society are guilty of not paying enough attention to. We have to solve the problem of malnutrition ourselves; no foreign agency/government or research outfit can do it for us.
If we want to ensure the health of our children, they cannot be seen in isolation: they are part of their mothers, who are dependent on their husbands. Unless we see this linkage, we will not achieve the outcomes we are looking for. At the macro-level, the quality of drinking water, sanitation provisions and the social security net required to enable even wage-earning mothers to rest for the first few months after delivery become crucial determinants for eliminating malnutrition, which affects nearly one out of two children in our country.
Malnourished children often inherit the condition or the predisposition to the condition right in the womb of the mother. Early marriage and early motherhood make the case so much harder to reverse. The education, social welfare and health ministries have to complement the child and woman welfare ministry in this fight. The statistics on diarrhoeal deaths among children proves that there is an acute need for aligning the water and sanitation ministries. Added to these, the challenges of the Centre-state relations and budget allocations.
Having seen the gaps in the way the different ministries operate, one wonders if we need to set up a constitutional body like the Election Commission to battle this scourge. Maybe we could set up a nutrition commission or a nutrition ministry to oversee the convergence of the relevant schemes. The irony is that, while all our ministries are expected to work in tandem if the child is to survive, nourished and healthy, we have left childcare to anganwadi workers, who along with filling datasheets about the children are also expected to handle on an average over a 100 children. In some cases, like in villages in UP and Bihar, this number is 500-plus.
How can we use technology to make data real time so that each child can be tracked on a daily basis? How can we make mothers an integral part of the ICDS programme? After the successful Self Help Group (SHG) movement, can we proactively create the next revolution of Mothers' Nutrition Groups in villages? They could be empowered with the adequate knowledge, monitoring tools and decision-making powers to meet the demands of children. Moreover, we need to make mothers aware that breast-feeding for the first six months is a must. Plus, we need policies to safeguard maternity leave benefits in the unorganised sector.
Over the last few years, as a group we have demonstrated that there is political consensus to work towards making India a malnourishment-free nation. What is needed is the air cover to convert this into strong policies, political will and concerted action as though we are dealing with a national emergency.
For this civil society, media, youth and businesses need to make this a non-negotiable agenda. If that happens, India will be the world leader in the newly defined GNP (gross nutrition product) for children.
Manoj Kumar is CEO, Naandi Foundation. He is a member of the Citizen's Alliance to Fight Malnutrition. The views expressed by the author are person.