45,000 children die of malnutrition every year in Maharashtra

As a report by the NGO SATHI shows, a healthy GDP is no indication of the health of a state or a country’s children

Despite being among the wealthiest states in the country, almost half Maharashtra’s children are undernourished and one-third of adults are underweight, says a recent report by the NGO SATHI.

Forty-five-thousand children die of malnutrition every year in the state, according to ‘A report on nutritional crisis in Maharashtra’ by the Pune-based SATHI (Support for Advocacy and Training to Health Initiatives). One-third of adults are underweight, and 15% severely underweight.

The two major schemes for children meant to prevent such deaths are the midday meal scheme and the Integrated Child Development Scheme (ICDS). But the state government spends just 0.8% of its gross domestic product on these schemes, the report states.

More children die of mild or moderate malnutrition (33,000) than of severe malnutrition (12,000). Malnutrition is also the underlying cause of death of 480 of the 2,850 malnutrition deaths in the state every year.

“A large number of people in Maharashtra do not get enough to eat and are suffering from serious nutritional deficiencies,” said the coordinator of SATHI, Abhay Shukla, at a press conference to release the report on February 3, 2010. The report takes into account the findings of the National Family Health Survey-3 and the National Sample Survey.

The report points out that chronic hunger is not confined to rural areas, as is popularly believed; urban populations in coastal regions, including the city of Mumbai, have the highest prevalence of calorie deficiency (43%) in the state. Calculations made using the per-consumer-unit-calories norm of 2,400 in rural areas and 2,100 in urban areas reveals that the incidence of calories-based poverty is 54% in rural areas and 39.5% in urban areas.

The report is critical of government schemes like the ICDS. Grade 3 and 4 malnutrition is grossly underreported under the scheme as workers lack the skills and equipment to accurately weigh and classify children. Severe malnutrition is often underreported as it points to a failure of the programme.

The midday meal scheme too has been underperforming, according to the report. Only 12% of schools surveyed provided midday meals, and many gave only one component of the meal. Moreover, not a single school provided the stipulated 300 calories and 8-12 grams of protein.

India’s performance on the nutrition front is poor overall. According to the National Family Health Survey-3 (up to 2005-06), almost half of children under 5 years of age (48%) are stunted, that is, too short for their age, an indicator of chronic malnutrition; 43% are underweight. The proportion of severely undernourished children is also notable -- 24% are severely stunted and 16% are severely underweight.

The 2009 annual budget earmarked just 4.15% for children when the population under 18 years of age is 447 million.

Maharashtra’s poor performance on the health front comes despite it being one of the high GDP states. Though the country as a whole has seen GDP grow by 3.95% per year, between 1980 and 2005, the percentage of underweight children under 3 went down by just 6%, from 52% to 46% between 1992 and 2005. For every 3-4% increase in per capita income, the underweight rate should decline by 1%. This has not happened in India, pointing to the need for more inclusive growth and better delivery and distribution of schemes targeted at malnutrition.