The Double Burden Of ‘Malnutrition’ And ‘Mall-nutrition’

by | Feb 5, 2018

Baiganwadi is one of the oldest and largest waste dumping ground in Mumbai, located in Govandi (East). The slum here is densely populated as several people share a small same room (10ft. x 15ft.). The population exceeds 2lakh and Muslim community holds the majority. Only a small percentage of the people has access to hygiene and safe drinking water. More than 80% of them are living below poverty line.

Fight Hunger Foundation in Govandi is currently working with children and their families for prevention and management of acute malnutrition. While working with this organisation in the past, I met people living in this slum and got an opportunity to take a closer look at malnutrition.

There, I met Saira*, mother of 3 – Furkan (7 months), Rehan (2 years) and Afsha (4 years). She came to this organisation when Rehan was found to be SAM (Severely Acute Malnourished), after which he was treated and got cured. After a month, Rehan was again found to be under MAM (Moderately Acute Malnourished). When I interviewed Saira regarding the previous experience, she said that it was painful to see her child weak and sick all the time. Due to improper care, she couldn’t breastfeed Rehan after 8 months which worsened the case. Now Rehan is inclined to eat cheaper unhealthy junk food which is easily available on the streets and hence doesn’t consume home-made food. Saira attributes this poor diet to not only their inability to purchase high-quality food but also to her lack of control on her family’s diet due to the patriarchal culture where men make most decisions. Moreover, she had no say in the number of children she wanted which had deteriorated both her and children’s nutritional health.

From what I’ve seen, other than lack of nutritious food or poverty, malnutrition has multiple root causes which in turn leads to ‘mall-nutrition’, i.e. consumption of junk food. There has been an increase in the replacement of home-made food with cheap unhealthy junk food available on the streets, which is also leading to malnutrition among children. In my view, this issue extends beyond healthcare system’s capacity to treat malnutrition and calls for an immediate attention and awareness to the dangers of junk food consumption. Low-income families not only have constrained financial resources but also limited knowledge due to which the problem is compounded. If they were to invest money efficiently, it would give returns in terms of nutritional value and healthy life in later years.

Malnutrition is directly or indirectly affecting our country’s productivity. A recent country report by National Family Health Survey (NFHS-4) has revealed that though the prevalence of stunting and underweight (children under 5 years) has decreased, yet, the levels of child malnutrition continue to be high.

According to the World Bank, India is one of the highest-ranking countries in the world for children suffering from malnutrition. In terms of poverty, India ranks 21 in the world. The prevalence of underweight in children in India is among the highest in the world. One in every four of the world’s malnourished children lives in India. Also, the Global Hunger Index has ranked India 20th among leading countries with a serious hunger situation in 2015.

Gaps can be seen in nutrition programming in the country at all levels. There is no institutional mechanism in place to ensure regular availability of anthropometric data at national, state and district levels. The first step towards meaningful planning and monitoring would be to put in place a regular and comprehensive nutrition surveillance system and incorporate it with the Mother and Child Tracking System (MCTS). This multi-sectoral comprehensive approach towards tackling malnutrition in all its forms might help in achieving the Sustainable Development Goal 2.2 which calls for ending all forms of malnutrition by 2030, and achieving the internationally agreed targets on stunting and wasting in children under five years of age by 2025. It’s a rocky road ahead and difficult to achieve this in our country, but it is possible.

*Names changed to protect identity

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