Nutritional Security in India- Significance and Challenges- Explained Pointwise

The recently released NSSO’s Household Consumption Expenditure Survey (HCES) 2022-23, provides fresh insights to access nutritional security in India. HCES 2022-23 report provides detailed data on the consumption of various food and non-food items by households and calculates the per capita daily calorie intake.

These findings highlight the prevailing nutritional insecurity in India. The policy focus of the Government of India must on ensuring nutritional Security along with food security.

What is Nutritional Security? What is the Status of Nutrition insecurity in India?

Nutritional Security- According to the FAO (2009), nutrition security implies physical, economic and social access to balanced diet, clean drinking water, safe environment, and health care (preventive and curative) for every individual.

High Nutritional Insecurity in India (Malnutrition)- According to World Bank Report, despite the sharp decline in extreme poverty in India from 45.9% to 13.4% between 1993 and 2015, India still suffers from a high malnutrition burden.

Latest Findings of NHFS-5 regarding malnutrition

Double Burden of Nutritional Insecurity- According to a new Lancet study, there has been a steady increase in obesity levels in India. India has become one of the countries with a high ‘double burden of nutritional insecurity‘, with the increase in both malnutrition and the obesity levels.

What are the reasons for the lack of Nutritional Security in India? 

There are multiple reasons behind the lack of nutritional security in India. These are explained below-

1. Affordability Issues for the Poor Household- Affordability of nutritious food products, such as green leafy vegetables, protein-rich diet, has become difficult for the poor households in India. The increasing wealth inequality, with top 10% of Indians holding 57% of the national income, has exacerbated nutritional insecurity.

2. Focus on Staple Crops- Agricultural policies, like Green Revolution, have prioritized the production of staple crops like wheat and rice over diverse, nutrient-rich crops. This has led to micronutrient deficiencies amongst the population.

3. Calories Fundamentalism- The focus of the Public Distribution Scheme has been limited to ensuring food security and calorie requirement. The need for nutritional development has not been taken into account.

4. Feminine marginalization in Nutrition- The nutritional requirements of adolescent and young female in poor and lower middle income households are not prioritized. This leads to malnourished female population and their offsprings. For ex- Large prevelance of anemia due to inadequate focus on iron deficiency in female diet.

5. Laxity in effective implementation of Child Care practices- Child caring practices, including exclusive breastfeeding, and introduction of complementary food and a diversified diet after the first six months, are not implemented properly. For ex- Only 55% of children in India were exclusively breastfed in 2015-16.

6. Growth of Fast-food and junk-food Culture- Cheaper and easily available junk food has replaced the nutritious food in the dietary intakes of Indian population. For ex- According to recent Household Consumption Survey, Indians are spending less on cereals and pulses and more on beverages, refreshments and processed food.

7. Increased income and urbanization- Increased income levels have led to a rise in the consumption of foods high in fats, sugar, and low physical activity. According to a joint study conducted by WHO and ICRIER, India’s ultra-processed food industry has grown at a CAGR of 13.37% in terms of retail sales value between 2011 and 2021.

What are the negative effects of malnutrition?

1. Child Deaths- According to a lancet Study in 2019, a staggering 68% of 1.04 million deaths of children under five years in India were attributable to malnutrition.

2. Improper development of Children in formative years- Obesity in children results in stunted physical and cognitive development.

3. Psychosocial Impact- Malnourished Individuals face psychosocial challenges like, body image issues and mental health concerns due to societal stigmas associated with weight.

4. Economic Burden- Malnutrition increases the economic burden due to productivity losses on account of decreased work efficiency and absenteeism.

5. Social Inequality and Disparities- Undernutrition and malnutrition perpetuates a cycle of health challenges and economic disadvantages amongst the vulnerable sections, exacerbates existing socio-economic disparities. Women are disproportionately affected by malnutrition, facing challenges related to reproductive health, maternal health, and overall well-being.

What Initiatives have been undertaken to provide for Nutritional Security in India?

What Should be the Way Forward?

1. Change in the Policy Focus- The agricultural policies and programmes should be leveraged to be more ‘nutrition sensitive‘. The focus of food distribution programmes need to shift from ‘calories fundamentalism’ to providing a more diversified food basket, including coarse grains, millets, and pulses to improve the nutritional status of pre-school children and women of reproductive age.

2. Innovative approaches- Innovative techniques such as bio-fortification, which involves incorporating nutrients into the seeds of major food grains will help to improve the micro-nutrient intake. Various food-based safety nets such as PDS, MDM can include bio-fortified staples to provide a more diversified food basket.

3. Enhanced Focus on WASH initiatives- Synergy between WASH initiatives (safe drinking water, sanitation and hygiene) and nutritional interventions will have a multiplier effect on nutritional outcomes. This will help in improving child nutritional outcomes and are key to the success of nutritional interventions.

4. Focus on Women education- Targeted programs for improving the educational status of girls, particularly at the higher educational levels, need to be promoted. This will help in better implementation of child care practices like breastfeeding and nutritional needs of children.

5. Improving health care services- Improvement of access and utilization of prenatal and postnatal health care services must be prioritized. It would play a significant role in curbing undernutrition amongst children through
comprehensive awareness programs and community participation.

6. Successful International Interventions- India can draw key lessons from these developing countries to tackle the challenge of food insecurity and malnutrition. For ex- Brazil has transformed its food system and is investing in agricultural R&D and social protection programs to reduce the level of hunger in the country. China has attached great importance to early childhood development and has formulated a series of plans in this regard.