A nutritional crisis in India

Illustration by Jayachandran/Mint

Live Mint :Tue, May 14 2013. 09 51 PM IST

Some commentators have gone so far as to dismiss India’s nutritional crisis as a ‘hoax’

In a recent article, Columbia University economist Arvind Panagariya argued that India need not be ashamed of its malnutrition statistics as they are likely to be exaggerated.

Panagariya’s contention that international standards used to measure nutritional attainments of Indian children are inappropriate, as they fail to account for “genetic differences” seem to have found favour with other commentators, who have gone so far as to dismiss India’s nutritional crisis as a “hoax”. Just as reform critics see India’s malnutrition statistics as an indictment of the reforms process, Panagariya’s hypothesis of exaggerated malnutrition figures is seen as an exoneration of reforms.

There are several problems with such arguments. 

First, the hypothesis that genetic differences could account for growth differences is a very old one, and one that has been repeatedly dismissed by several studies, including the one by the World Health Organization (WHO) which led to the introduction of new international growth norms in 2006.

Second, while malnutrition sceptics emphasize India’s higher child survival figures as compared to sub-Saharan Africa—where the proportion of underweight children is half that of India—they tend to ignore the higher proportion of low birth weights in India. As several studies by nutritionists show, the root of high malnutrition in India (and much of South Asia) lies in the low social status of women. Unhealthy mothers, in turn, give birth to low birth weight children, who turn malnourished. 

Third, although malnutrition does not always lead to death in India, it can still be quite dangerous.

 A growing body of evidence suggests that low birth weights of Asian children are related to obesity related disorders, much later in life.

To be sure, it is true that eliminating the nutrition gap between India and the rest of the world may take several generations.

 But this is no reason to abandon international growth norms, nor does it imply a permanent “genetic difference”. Indeed, this gap should motivate India to redress gender inequities quicker, invest in cost-effective preventive health systems and reform her decaying nutrition institutions such as the Integrated Child Development Services (ICDS). 

Even if South Asian children were genetically predisposed to being smaller, it still does not explain why India should lag behind poorer neighbours such as Bangladesh and Nepal in nutritional outcomes.

Finally, India’s malnutrition figures must not be seen as an indictment of the reforms process; rather, they are an indictment of our unreformed public delivery systems, and of our long history of gender bias.