2. INTRODUCTION
India, today is one of the most
malnourished countries in the World.
More than 40% of the World’s under
weight children below five years live in
India (Global Hunger Index 2007)
The latest NFHS 3 asserts that not much
progress has been achieved in improving
human resources.
Poverty is a major, but not the only cause
of malnutrition
Percentage of population suffering from
various forms of malnutrition, far exceeds
the percentage below poverty lineToday,
India has no national program to combat
malnutrition
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3. (i) India has no comprehensive National Program for the eradication of
Malnutrition. The ICDS programme in governmental and general
perception is seen as a programme to address malnutrition. However,
ICDS is not a programme for the eradication of malnutrition, but for
Integrated Child Development.
(ii)Other Nutrition and related programmes such as the Mid Day Meal
Programme, Kishori Shakti Yojana, Vitamin A supplementation
programme, National Nutritional Anemia Control Programme, and the
National Iodine Deficiency Disorder Control Progreamme address some
of the causes of Malnutrition but not all of them.
(iii) Malnutrition in India is deeply rooted in the inter-generational cycle.
However, the current policies and programmes do not address the issue
inter-generationally, as depicted in the diagram.
3
Analysis of the current situation:
4. (iv) The population of India suffers from a high Protein Calorie deficit.
Studies reveal that 30% of the households in India consume less than
70% of the energy requirement and calorie intake(NNMB repeat surveys
1988-1990 and 1996-97).
(v) There is inadequate awareness and information regarding proper
nutritional practices amongst the population.
(vi) Crucial prescriptions of the National Nutrition Policy, 1993, were not
translated into National Programmes, viz., popularization of low cost
nutritious foods, reaching the adolescent girl, fortification of essential
foods and control of micronutrient deficiencies.
(vii) Most importantly, eradication of malnutrition should be articulated as
high priority in the National Development Agenda.
4
Analysis of the current situation:
5. Male malnutrition intrinsically begins with maternal
malnutrition
28.1% of the men in India have Body Mass Index below normal
Stunted stature and low body weight of men due to
malnutrition results in Chronic Energy Deficiency
24.3% of the men in India are anaemic
Anaemia reduces work capacity and results in low productivity
Percentage of men suffering from anaemia ranges from 7.1% in
Kerala to 44.6% in Assam
Percentage of men having below normal BMI and suffering
from anaemia is higher in SC and ST population.
5Cont… 5
Nutritional Status of Men in INDIA
6. Malnutrition negatively impacts the GDP as it reduces physical/ cognitive
growth, reduces productivity and earnings of individuals, and results in
economic loss to the nation.
It lowers the resistance of the body to infections and capacity to recover from
illness and adds to the health costs of the nation.
Protein Calorie Intake, Micronutrient Intake, Infections and illness,
Nature of Occupation determine working capacity and income generation
capacity
Based on the findings of NNMB repeat surveys in the years 1988-90 and 1996-
97, that 30% of the households consume less than 70% of energy requirement,
an attempt has been made to calculate loss of productivity in adults, and the
resultant economic loss to the nation as a result of malnutrition. This equals
approximately US $ 72 Billion (4% of GDP). 6
What Does Malnutrition Cost The
Nation
7. Total no. of households in India= 193,579,954 (Census of India 2001)
30% of households =58,073986 consume less than 70% of energy
requirements (NNMB Repeat Surveys in 1988-90 and 1996-97)
Norm level of calorie intake: 2700Kcal
Actual Calorie Intake: 1890 Kcal (70% of 2700Kcal)
Energy required for Basal Metabolic Rate (BMR): 1515 Kcal
Calorie left for productive work: 375 Kcal (1890 Kcal- 1515 Kcal)
Heavy work requires 219 Kcal per hour.
Moderate work requires 122 Kcal per hour.
Work hour lost per day per person due to inadequate calorie
consumption: 4 hours of moderate work and 7.5 hours of heavy
work
GDP Loss Due To Calorie Deficit
8. Calculated on the formula:
Ea X Total No. of days in year (365)
Er X Total No. of working days in year (250)
Ea: is the Energy available for work: 375 Kcal
Er: is the energy required for a particular work: 219 Kcal for heavy work and 122 Kcal for moderate.
Assuming average household has 5 Consumer Units,(NSS in Nutritional Intake
in India, 50th Round, July 1993: June 1994) then total no. of population
consuming less than norm level for calorie intake= 290,369,930
55% of Adults= 159,703,461.
Based on actual average wage of Rs. 240/- per man per day of 8 hours, per
hour earning = Rs. 30/-
Loss of total money due to low productivity due to inadequate calorie
consumption = Rs. 120/- approx. per day per person.
Total money lost by entire adult population per day= Rs. 19,164,415,320
GDP Loss Due To Calorie Deficit
9. Assuming total of 250 working days, total money lost in a year =
Rs. 4,761,775,920,000 = US$ 72,148,120,000 approx. (1 US$= Rs.
40/-) = Approx. US $ 72 Billion
Total GDP for year 2012-13 = (approx.) US$ 1.8 trillion
GDP loss = 4% GDP
In absence of reliable data this study does not take into account
the productivity loss through protein and micronutrient
deficit.
GDP Loss Due To Calorie Deficit
10. Adolescents
learn better &
achieve higher
grades
in school
Girls & women
are well-
nourished and
have healthy
newborn babies
Families &
communities
emerge out of
poverty
Communities &
nations are
productive &
stable
The world is a
safer, more
resilient &
stronger place
Young adults
are better able
to obtain
work & earn
more
Because when..
Children receive
proper nutrition
and develop
strong bodies &
minds
WHY NUTRITION…??
11. Underlying Principles: Bridging the Calorie-Protein Gap
Introduce nutrition and micro-nutrient interventions for the three
critical links of malnutrition viz. children 6 months – 6 years, adolescent
girls, and pregnant and lactating women to be prepared by SHGs from low
cost, locally available agricultural produce.
Introduce nutrition and micro-nutrient interventions for the general
population to bridge the protein-calorie gap by making available in the
market, protein-energy dense foods.
Make available low cost energy foods for the general population
(Corporate Sector/PPP)
Structure and monitor tightly integrated multi-sectoral interventions to
address all or majority of the direct and indirect causes of malnutrition
simultaneously.
Initiate a sustained general public awareness campaign regarding proper
nutritional practices within existing family budgets, and to create
demand. 11
A National Strategy To Combat
Malnutrition
12. A computerized Central and Block level monitoring systems
should be devised with deliverable targets and time frames
An effective concurrent monitoring system through an external
agency can also be established for measuring outcomes, and for
effecting changes and mid course corrections
At the AW level, community based nutrition monitoring and
surveillance through ICDS infrastructure could include growth
monitoring of infants and children and weight monitoring of
adolescent girls and women
Creating a data base on the nutritional status of children,
adolescents and women in each Anganwadi
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Nutrition Monitoring and Surveillence
13. Since at least 4% of India’s GDP ($1800 Billion) annually is lost on
account of malnutrition, the cost of addressing malnutrition is far
below the cost of not addressing it.
It may be noted that the cost of construction of 3 kilometres of
rural road is in excess of the amount required to address the
nutrition deficit of the key target groups in the Block.
Investing in human resources development for the future – in the
shape of healthy children, adolescents and adults with higher
cognitive and productive capacity, is an investment that will pay
for itself several times over, will eradicate the curse of
malnutrition in the shortest possible time, so that every Indian is
able to reach his or her full physical and cognitive potential,
enhance income generation capacity and contribute to the
country's progress.
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Concluding Observations