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THIRUVANANTHAPURAM, India, Jan 21 2012 (IPS) - Even a year after Rani, a three-year-old tribal girl in the backward Wayanad district of southern Kerala state, was treated in a government hospital for gastroenteritis she remains grossly underweight and suffers from frequent bouts of diarrhoea.
Rani is one of millions of children in India who are victims of a faulty and neglectful public healthcare system that is proving to be an obstacle to human development in this rapidly growing economy of 1.1 billion people.
Earlier this month Prime Minister Manmohan Singh called malnutrition “a national shame” while releasing the report of a survey conducted by a coalition of non-government organisations (NGOs) that found 42 percent of Indian children below five underweight.
The report, called ‘Hungama’ (short for hunger and malnutrition and meaning uproar in the Hindi language), was based on a survey of 73,000 households across nine states.
Singh lamented that “despite impressive growth in our GDP, the level of under-nutrition in the country is unacceptably high.” He urged planners to “understand the linkages between education, health, sanitation, hygiene, drinking water and nutrition.”
Dr. R. Jayaprakash, associate professor of paediatrics at the Government Medical College, Thiruvananthapuram, told IPS that child malnutrition is mostly the result of poverty and inappropriate feeding practices.
Studies conducted by the National Institute of Nutrition (NIN) in Hyderabad show that 45 percent of children in rural areas are underweight and that 49.6 percent of them show evidence of stunted growth.
Dr. A. Laxmaiah, deputy director at NIN, told IPS that besides poverty and faulty infant and child feeding practices, ignorance is an important factor contributing to the high malnutrition rate. “Nutritional illiteracy is seen even among educated people.”
A World Bank Report released mid-2011, ‘Undernourished children – a call for reform and action’, estimated that some 60 million children were underweight in India. The report also said 50 percent of India’s 1.1 billion people live on less than 1.25 dollars a day.
The United Nations Information Centre (UNIC) in New Delhi says India can easily tackle malnutrition. “As a food surplus and grain exporting nation, India can and must address malnutrition, which is caused by structural neglect and systematic failure, with resolute government and alternative interventions.”
The 2011 MDG report of the U.N. highlights the point that any real progress towards meeting the millennium goals must address the situation of the poorest and most marginalised sections. In India, this refers mostly to dalit (low caste) and tribal children.
National family health surveys conducted over the last 15 years by the government have shown under- nutrition rates to be highest among dalits and tribal children and constant at 55 percent.
Dr. Sivakumar, a Pondicherry-based social activist who works to improve the health of tribal children, told IPS that poor sanitation, lack of safe drinking water, inadequate healthcare facilities, vector-borne diseases and social barriers are among reasons for the higher prevalence of malnutrition in tribal areas.
Dalits and tribal people together make up about 25 percent of India’s population.
The government’s Integrated Child Development Services (ICDS) programme launched in 1975 is yet to make a dent in child malnutrition. Consequently, the Bank in its 2011 report called for “urgent changes to bridge the gap between the policy intentions of ICDS and its actual implementation.”
Anjali Verma, an activist in the child healthcare sector in Mumbai, told IPS that developing care-giving in communities has proven to be cost effective in fighting child malnutrition, but requires substantial investments at the grassroots level.
“Funds for child welfare schemes are being misused by some state governments in northern India. Any kind of misuse of nutritional schemes will affect achievement of MDGs,” she said.
The National Food Security Bill, which is expected to be passed by parliament this year, seeks to provide specific entitlements for pregnant and lactating women and children below the age of six.
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