A recent report revealed, undernourishment in children remained rampant in India, especially in Uttar Pradesh – the most-populated state, tribal-dominated Jharkhand, Bihar, and even Andhra Pradesh.
It was based on a study of 220,000 children aged 0-5 years across 3,940 Legislative Assembly constituencies from geographic regions covered in the National Family Health Survey, 2015-2016. The data were analyzed by a group of public health and population science researchers from universities in the United States, South Korea, and India based on the four undernourishment indicators including stunting, being underweight, wasting, and anemia, among children up to five years.
There have been earlier attempts of studying child undernourishment, the authors of Estimating the Burden of Child Undernutrition for Smaller Electoral Units in India looks into assembly constituencies, making it a first-of-its-kind study.
At a macro level, a coherent trend emerges by mapping the various assembly constituencies based on the four undernourishment indicators: 37 assembly constituencies in Thrissur, Ernakulam, Idukki, and Palakkad districts show high undernourishment levels in at least three of the four indicators.
In Bihar, 238 of the 244 assembly constituencies studied had a high prevalence of stunting, 238 showed high underweight levels; 118 had a high prevalence of wasting and 221 had a high prevalence of children suffering from anemia.
Jharkhand, which was split from Bihar, mirrored Bihar’s trends in many ways: 81 of the 95 constituencies studied had a high number of stunted children, 89 had a high number of underweight children, 86 had a high proportion of wasted children and 88 constituencies had high anemia prevalence in the age group.
The study also highlights the uneven distribution of undernourishment: No state fared badly in all four indicators. Punjab, for instance, reported a high prevalence of anemia but a low prevalence of stunting, underweight and wasting. Policy initiatives driven by assembly constituencies can be more precise with greater political accountability, the researchers wrote, explaining how they selected their study units. The paper added:
A member of a legislative assembly “votes on demands for grants in the budget, and decides on governance lapses, as brought by audit reports by the comptroller and auditor general”, the researchers observed.
Parliamentary constituencies are fairly large units, with substantial heterogeneity within them, according to the researchers. “Assembly constituencies, on the other hand, are local electoral units that remain unexplored.”
The four chariots of malnourishment
Down To Earthanalyzed the data from the study to identify the constituencies that fared worst across the four indicators.
Stunting: Nine of the top 10 constituencies were from Uttar Pradesh, including the worst performer — Ghorawal (60.94 percent).
Underweight: Jharkhand, Maharashtra, and Andhra Pradesh had three constituencies each in the top 10 list, and Karnataka had one.
Jharkhand’s Khunti was the worst performer, according to the report. All the top five constituencies in the ranking were under reserved seats (scheduled caste / scheduled tribe).
Wasting: Nine of the 10 constituencies with the highest proportion of wasted children were spread across Karnataka (4), Jharkhand (3), and West Bengal (2). Jamua in Jharkhand, scheduled caste assembly seat, topped the chart. Radaur in Haryana ranked 7th, the report showed.
Anaemia: Andhra Pradesh had the highest prevalence with eight of the top 10 constituencies. Basavakalyan and Aurad in Karnataka also feature in the ranking.
The causes of undernutrition in children in this age group are rooted in socioeconomic determinants distributed unequally across the country, according to the report.
The estimates that emerged from this analysis can help in identifying areas with a high malnutrition burden in areas where resources are scarce.
Rising costs of healthy diets and high poverty keep healthy diets out of reach for around 3 billion people on this planet. Under the shadow of the Covid-19 pandemic, all progress over malnutrition is under threat.
The situation could have been worsened without governments’ responses. Geographic targeting of public health interventions is needed to push a mainstream political agenda.
Dr. Rajiv Kumar, the vice-chairman of NITI Aayog, commented over the geographic interpolation of malnutrition data said: “In line with the ideals of India’s Constitution, this research will help public representatives at the middle and primary levels of governance lead united efforts in their constituencies to raise the nutritional status of children and women.”
Source: Down to earth, India Today