February 10, 2007

Even Amid Its Wealth, India Finds, Half Its Small Children Are Malnourished

MUMBAI, India, Feb. 9 — Even after India’s years of sustained economic growth, child malnutrition rates here are comparable to some of the poorest countries, and at times worse.

In this young nation, where 40 percent of the people are under 18, figures released by the government on Friday offered an alarming portrait of child health: Among children under 3, nearly half are clinically underweight, the most reliable measure of malnutrition.

Additionally troubling, the incidence of child malnutrition declined only one percentage point, to 46 percent, in seven years, according the latest National Family Health Survey. During that time, the economy grew at 6 to 8 percent; it is poised to swell by more than 9 percent in the current fiscal year, the government announced this week.

India’s economic prospects pivot in part around what it calls its demographic dividend.

But the child malnutrition rates put India roughly on a par with Burkina Faso and Bangladesh. Sudan posted better results, according to data compiled by the United Nations Children’s Fund, or Unicef. Malnutrition in China was about 8 percent, Unicef said.

The long-awaited health report, which was quietly made public on Friday on a government Web site, also showed scant progress in childhood immunization. In the survey, compiled in 2005-6, 43.5 percent of children 12 to 23 months old were fully immunized, compared with 42 percent in the previous survey, in 1998-99.

Poverty amid plenty is hardly new in India. But the latest numbers are startling because they suggest that economic growth has not significantly uplifted the most destitute, nor have well-meaning government efforts to improve children’s well-being yielded measurable results.

The nutrition figures also reflect the grinding poverty in parts of rural India, and poor public health and sanitation in general. The health survey measured how many households had access to a toilet (44 percent nationwide) and the proportion of children who suffered from diarrhea and who were given oral rehydration salts (58 percent).

“It’s partly poverty, it’s partly the collapse of health services, it’s a measure of a completely lopsided pattern of growth in the country,” said Jean Drčze, an economist who led a study of India’s child nutrition programs late last year.

The nutrition figures showed a wide disparity among states. In central Madhya Pradesh, malnutrition rates are around 60 percent; in Tamil Nadu, the rates have steadily improved, bringing malnutrition down to 33 percent.

The national figures could be seen as an indictment of an ambitious government-financed program, the Integrated Child Development Services, which is intended to help poor families feed their children.

The program has been dogged by criticism in recent months, from charges of corruption in some states to poor accountability elsewhere. Studies by both Unicef and Mr. Drčze’s group have concluded that in some places, children get only raw grains. Some workers were not properly trained and some mothers were inadequately counseled about feeding newborns.

Werner Schultink, who runs child development and nutrition programs for Unicef in India, called the latest figures “very disappointing.”

“It gives an indication that some of the programs are not as effective as they should be,” he said. In mid-January, Prime Minister Manmohan Singh went further in his criticism, urging state officials to review the child nutrition program.

“There is strong evidence that the program has not led to any substantial improvement in the nutritional status of children under 6,” he wrote in a letter, adding that for the government actually to keep its promise of providing nutrition to poor children, it would require close monitoring of the program, and “political will.”

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