Abstract

India has the largest number of undernourished people the world. Malnutrition is a major problem with nearly 55% of the pre-school children and one-third of women the age group 15-49 years being underweight. The problem of malnutrition is causing an economic pullback as India tends to lose 3-4% of the Gross Domestic Product (GDP) terms of loss of productivity. This glaring problem of malnutrition and micronutrient defi ciencies is multi-factorial. Important causes include lack of improvement agricultural productivity owing to inadequate resources, lack of education and inadequate job opportunities. Increased informal workforce due to rural-urban migration along with unplanned growth of slums is one of the key issues the urban set-up. Other factors catalyzing the problem include overpopulation, gender inequality, inadequate distribution of food through public distribution mechanisms and lack of coherent nutrition policies. The government policies should focus on growth agriculture and on improving the food storing facilities. An accurate targeting of in need population, so that they get food at substantially low price along with introduction of holistic employment schemes is required. Nutrition based programmes should have in-built system of evaluation based on key nutritional indicators. Social determinants of health such as water, sanitation and women empowerment also have to be addressed to achieve long term gains the health of the community. Community awareness and mass movement is required to ensure that demographic dividend might not turn into demographic nightmare. Keeping view that nutrition is not a 'stand alone' subject, a multisectoral approach is needed.

Highlights

  • Malnutrition is a broad term which refers to both under nutrition and over-nutrition

  • The current manuscript will focus on the under-nutrition aspect of malnutrition rather than over-nutrition

  • The problem of chronic hunger and malnutrition seems to prevail on a large scale in India and other developing countries

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Summary

INTRODUCTION

Malnutrition is a broad term which refers to both under nutrition and over-nutrition. India has the largest number of undernourished people in the world, 212 million – only marginally below the 215 million estimated for 1990– 92.[1] The Global Hunger Index (GHI) for India in the year 2010 was 24.1 which placed it in the “alarming category” (ranked 67, way below neighbouring countries like China and Pakistan).[2] This index was 31.7 in year 1990 which declined to 23.9 in 2009.[3] According to the NFHS-2 and NFHS-3 reports, 36.2% and 33% of the women (aged 15-49 years) respectively had their body mass index (BMI) below normal (a negligible change in the last seven years).[4,5] The findings are dismal in case of children with 45.9% of the children below the age of 3 years being underweight or malnourished, according to the NFHS-3 report.[5] Surprisingly, India is one of the few countries which has experimented with a broad spectrum of food based programmes like “Entitlement feeding programmes” (ICDS, Mid-day meal programme), “Food.

PRINCIPLE REASONS FOR EXISTING MALNUTRITION IN INDIA
Findings
WAY FORWARD
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