National Nutrition Week 2021: Food remains missing from most Indian tables

The impact of loss of income on nutrition levels of nearly 800 million underprivileged Indians could be alarming (MIG photos/Aman Kanojiya)

Emerging as one of the poorest countries at the time of independence 74 years ago, India was also prone to famines. However, since then, the country had come a long way, lifting hundreds of millions of its people from near-starvation to domestic food adequacy. It had also made significant progress in tackling malnutrition with several government schemes mainly targetting children and women and as result, the proportion of malnourished people, including the women and children, had been in constant decline.

This slow but significant progress, however, received a significant setback between 2015 and 2019, as the problem of malnutrition worsened across most of the major parameters, according to the National Family Health Survey 2019, the results of which were published late in 2020. The survey was impacted by the Covid-19 pandemic and data from some of the biggest states was collected before the pandemic hit the country and the other set was completed in November 2020. Unfortunately, the data of even those states which were surveyed before the pandemic showed a rise in the rate of malnutrition amongst children as compared to the previous survey conducted in 2015.

“I had recently read a report published last year which said that there were still 189 million people who were malnourished in India and there are 39 pc of children who are stunted. So, the situation is very bad and if you take a look at the data from NFHS IV and NFHS V, we have really taken a serious dip in terms of addressing both undernutrition and malnutrition. Only 30 pc women availed the services provided by the government about 50 pc pregnant women went to the nearest public health centre,” says Prachi Pandit, a nutrition expert and co-founder and director of Arbuza Regenerate, a company focused on addressing issues in population health.

According to the National Family Health Survey-5, in 13 out of 22 states and union territories, the percentage of children with stunted growth increased. Gujarat, touted as one of the most developed states and the home to Prime Minister Narendra Modi, topped the list of states with stunted children as 39 pc of all children in the state were stunted.

Pandemic impact not yet known

Pandit goes on to warn that the battle against malnutrition would have suffered a major blow during Covid-19 pandemic for a variety of reasons, including a focus on tackling the pandemic, lockdowns and the biggest ever job losses seen in India as close to 220 million lost their jobs due to the pandemic. But perhaps the biggest impact was the total disruption of several schemes of the government that were key in the battle against malnutrition. She goes on to say that the notion that pandemic propelled interest in health and healthy food is a false one, applicable to a small minority of the people.

“Pandemic propelled interest in healthy living and ayurveda but only in select households in the urban areas, while most of the rural families suffered a huge hit as there were far too many people totally dependent on services provided by the government such as hot meals provided to children in anganwadis (day care centres) and home visits by Asha workers who act as the interface for healthcare of most women, especially pregnant women, in the villages. All these services came to a total halt and we are yet to realise the real consequences of the break in these services and what we have seen so far is only the tip of the iceberg,” Pandit tells Media India Group.

Even though the Indian economy resumed growth in late 2020, it is far from returning to the pre-pandemic levels and the job losses have continued even as recently as the last month as the latest data by Mumbai-based research firm Centre for Monitoring of Indian Economy (CMIE) has shown. In its latest report, the CMIE said over 1.5 million people lost their jobs in August. Another worrying report showing the stress on household financial situation was a record jump in gold loans even as industrial credit dived. Analysts say that as gold is the saviour of last resort for most Indian households, especially the poor ones, the jump in gold loans shows household incomes remain depressed even 18 months after pandemic began. Pandit says low income immediately translates into low availability of food. “Whenever there is a problem of money in a family, the first thing which is compromised is food, in a rural family and in low socio-economic classes. The impact of this drop in income due to the pandemic is yet to be analysed by anyone and I think we need to be prepared for a big drop,” says Pandit.

Though the government has been claiming that it has provided food to over 800 million persons across the country throughout the pandemic, the truth seems to be elsewhere. A survey by Hunger Watch, an NGO, shows that a large number of poor families have reported that they now eat less nutritious food than before the pandemic.

What an ideal Indian meal should be composed of (Image: Arbuza)

The trouble for the low income and vulnerable sections of the society seems to have risen dramatically, with food inflation rising rapidly over the past several months. Experts believe that this would expose the poor to even more significant levels of malnourishment and undernourishment and flag that once again it is the women who may end up bearing the brunt of the problem. “Nutrition is measured in terms of kind and quantity and obviously both have cost attached to them. When there is inflation, what suffers first and the most is the food on the plate and whose food? The woman’s food because she eats the last and the least in a family, take any family. Thus, the food inflation is really going to hit the masses,” says Pandit.

Substance over symbol

Experts say that events like National Nutrition Week may be important in terms of nudges or symbolism in terms of bringing the focus on malnutrition, there is a need for much more to be done and that one week in a year does not suffice in either tackling the problem or even creating adequate awareness about it. “I would say that yes nudges like this are important, but once a year is too little. We should start a nutrition week every month until the time everyone realises that nutrition is just not about turmeric milk and avocado. It is much more pervasive and every bite that you take is making or breaking you. We need to drill this message about the importance of proper nutrition and how to get it constantly in our population, especially women, who remain prone to the worst form of malnourishment in most Indian households,” says Pandit.

She says that the message has to be communicated without a break until women realise the criticality of the quantity, quality and diversity of their food intake for not only their well-being but indeed of the entire family. “Women have been taking anaemia lightly and believe that if they are tired due to working it is normal. It is so difficult to convince such a person that she needs help and medicines, and which is why iron folic acid tablets are important for them. We need to bring about a complete behavourial change and for that we should come up with innovative social marketing methods to propel the uptake of these services and make these schemes interesting, accessible & aspirational,” says Pandit.

On the jump in interest for healthy food and exercise, Pandit remains sceptic and thinks it is more of a fad than something which is here to stay. “Sure, there is a section of urban population that really got interested in proper nutrition and healthy eating and people were exercising even at home, but I believe it was just for a small time period as soon as things become normal, we will come back to normal way of life. For things to really change about our lifestyle, the entire environment around us needs to change. We have to create an environment of good nutrition and health which should be around us all the time,” she says.