Over the last five decades, successive five-year plans have lain down policies and multi-sectoral strategies to combat nutrition related public health problems and improve the nutritional and health status of the population. Right to freedom from ‘Hunger’ and ‘Malnutrition’ has been recognized and briefly discussed by the Supreme Court in several PUCL (PDS Matters) versus Union of India judgments. For dealing with such “Human Rights” violation, National Human Rights Commission was set up through a statute named “The Protection of Human Rights Act, 1993.
Recently, National Human Rights Commission (NHRC), on February 18, 2020, has issued notice to the Uttar Pradesh government after taking cognizance of media reports on deaths due to malnutrition in several parts of Uttar Pradesh. The commission seeks it a grave violation of human rights to livelihood, food and adequate medical care.As per the definition of World Health Organization, ‘Malnutrition’, in all its forms, includes under nutrition (wasting, stunting, underweight), inadequate vitamins or minerals, overweight, obesity, and resulting diet-related noncommunicable diseases). in other words, malnutrition refers to deficiencies, excesses or imbalances in a person’s intake of energy and/or nutrients.
The global burden of malnutrition is unacceptably high, with nearly half of all deaths in children under five years linked to poor nutrition. While the Indian government is aiming at a 5 trillion dollar economy by 2024, the recent study of State of the World's Children 2019 published by UNICEF, has shown that malnutrition has caused 69 per cent of deaths of children below the age of 5 in India. Every second child in that age group is affected by some form of malnutrition. The report further states that almost 2 in 3 children between 6 months and 2 years of age are not fed food that supports their rapidly growing bodies and brains. This puts them at risk of poor brain development, weak learning, low immunity, increased infections and, in many cases, death, it said. On nutrition, India also ranked 102 nd among 117 countries on the Global Hunger Index (GHI), 2019; and according to the Indian government’s own National Family Health Survey (NFHS), 2015-16, more than 35.7 percent of children under 5 years of age are underweight, over 38.4 percent are stunted, and more than half of all children are anemic.
The undesirable impacts of malnutrition are significant in adults, too. For example, the Body Mass Index (BMI or the ratio of weight-for height) of a sizeable proportion of women (23 percent) and men (20 percent) in the age group of 15-49 is found to be falling below the norm.
According to Census 2011, with a population of nearly 22 crores, Uttar Pradesh is the most populous state in India. According to the NITI Aayog Health Index Report of 2019, Uttar Pradesh was the least performing state in relation to protection of death caused due to malnutrition. NHFS 2015-16, states that BMI below normal is most evident in Bihar, Jharkhand, Madhya Pradesh, and Uttar Pradesh.
Thus, Various government initiatives have been launched over the years which seek to improve the nutrition status in the country. These include the Integrated Child Development Services (ICDS), the National Health Mission, the Janani Suraksha Yojana, the Matritva Sahyog Yojana, the Mid-Day Meal Scheme, and the National Food Security Mission, among others. However, concerns regarding malnutrition have persisted despite improvements over the years.
Earlier, in the year 2013, an effort was made to address the hunger nutrition challenge through the enactment of the National Food Security Act. The law aims to ensure greater access to adequate quantity of quality food at affordable prices; but 2015 survey by Swaraj Abhiyan, a political organisation, reveals unsatisfactory progress in 34 the implementation of the Act. Data samples collected from Uttar Pradesh show that at places experiencing famine-like conditions, barely half of the poor families had eaten any pulses in the 30 days preceding the survey.
Compounding other economic and political factors that abet deaths due to malnutrition are social and cultural challenges that tend to defeat the very purpose of a nutrition programme. To begin with, India's massive population comprises such diverse community groups, of whom over 200 million (16.6 percent) are classified as 'scheduled castes'. A plan, for instance (named Hausla Poshan Yojana) to provide nutritious food to pregnant women and malnourished children in Uttar Pradesh failed to even take off because there were supposed women beneficiaries who refused to
consume the food prepared by Anganwadi workers belonging to the scheduled caste community, who have been historically regarded as untouchables by the upper castes. I think that such problems will continue unless greater efforts are made to strengthen the existing initiatives [such as the Public Distribution System (PDS), Mid-day Meal Scheme, Integrated Child Development Services (ICDS), Village and Child
Development Centres]. So, the Uttar Pradesh state government has to wake up and should pull up their socks for action against increasing number of deaths due to malnutrition. Moreover, it will be interesting to see the approach of National Human Rights Commission towards giving directions regarding hunger deaths to the yogi sarkar.