Connect with us

Analysis

India needs to holistically tackle child malnutrition

As a result of the programme, chronic malnutrition halved from 47.9 percent in 2009 to 25.2 percent in 2015. Stunting among children also dropped from 29 percent to 14 percent between 2007 and 2014.

Published

on

It is no secret that India has had an appalling record in keeping her children healthy. The country records deaths of over a million children annually before their fifth birthday due to under-nutrition-related causes. For matters of comparison, that number is higher than the entire population of Bhutan. Among the ones lucky enough to survive, more than half end up anaemic and almost 40 per cent are either stunted or underweight.

It is shocking that despite losing precious segments of its population each year, discussions around its causes in the mainstream media are virtually non-existent.

Amartya Sen and Jean Dreze tested how frequently issues of health found their way into the editorial pages of India’s leading dailies. It turned out that in more than 300 articles between January and June 2000, there was not even a single health-related one. In a second test during the last six months of 2012, they found health coverage in merely one per cent of the total editorial pages.

Considering these trends, it has been a refreshing change to witness a topic like nutrition coming into vogue in Indian policy corridors. Most recently, the NITI Aayog has come up with a 10-point action plan to tackle the menace of undernourishment in line with Prime Minister Narendra Modi’s vision of “Kuposhan Mukt Bharat” — in consonance with his ideas of Swachh Bharat and Swasth Bharat.

The document calls for state-customised action plans to address local nutritional needs and has set a few targets for measurable outcomes that are to be achieved over the next five years. However, there are a few issues in adopting such an approach.

The most glaring one is that the government has seen some progress through its schemes and programmes but has failed to make a substantial impact. The Integrated Child Development Services (ICDS) for children aged 0-6 by the Women and Child Development Ministry and the Infant and Young Child feeding practices by the Ministry of Health and Family Welfare are a case in point.

According to the National Family Health Survey estimates, only an estimated 170,000 children receive the treatment they need under these schemes out of a total of 930,000 children who have severe acute malnutrition (SAM) with medical complications. An outreach of 18 percent for a problem so acute is hardly satisfactory.

Another problem with asking the states to develop local agendas to combat a problem like malnutrition is the widespread limitations in general understanding of the concept. This has been evident in the recent debate around the use of packaged ready-to-use therapeutic food or energy/nutrient-dense supplements in government programmes and projects.

The opponents of the practice colour the use of these therapeutic foods as an international corporate agenda driven by profit motives. They usually argue for the use of freshly-cooked meals made locally and to do away with the idea of providing standardised therapeutic food.

Such arguments lead to a misunderstanding and misrepresentation of the problem of malnutrition. SAM is a medical condition that cannot be treated with mere provision of food. Ready-to-use therapeutic foods are ln effect medicines that provide the holistic and standardised set of nutrients and caloric density that are indispensable in dealing with malnutrition.

Moreover, freshly-cooked food at the ground level comes with its own set of problems that have cropped up from time to time in government-initiated programmes. Leaving the responsibility of cooking meals in the hands of individuals who are not experts leaves the possibility of contamination of food, which can only worsen the problem.

Therefore, in case the fight against malnutrition is taken up on a segmented basis, such knowledge gaps are bound to creep in and undermine the process. India needs a defined national agenda that can achieve the short-term goals set by the NITI Aayog. A measured mix of the right incentives and market-based solutions can be of substantial help. The case of Peru, which witnessed one of the most successful achievements in the world in reducing malnourishment, offers a viable solution.

Peruvians had suffered from a similar problem of child malnourishment as India currently does. About one in three children under five years of age were suffering from chronic malnourishment in 2000. Over the next few years, the country spent an estimated $200 million annually on nutrition programmes, but hardly saw any improvement. From 2007 onwards, the Peruvian government undertook a nationwide effort in coordination with local governments, health professionals and NGOs to focus on a specific set of goals and targeted policy initiatives to improve child nourishment.

The first thousand days of a child’s life were put in focus. A World Bank-backed conditional cash transfer programme was also implemented where the mother was incentivised to conduct regular health and growth check-ups for children in the first three years in return for a monthly cash transfer of $30.

As a result of the programme, chronic malnutrition halved from 47.9 percent in 2009 to 25.2 percent in 2015. Stunting among children also dropped from 29 percent to 14 percent between 2007 and 2014.

In the Indian context, such an approach can address both the issues outlined above. Low outreach of government programmes is eliminated with a monetary incentive to participate and the problem of knowledge gap is overcome by regular interaction of the parents with the community frontline workers who can administer the therapeutic food if needed.

Keeping such an approach in mind, a federal guideline for the states with clearly defined safety and standardisation parameters is required on an immediate basis for easy adoption and impactful intervention on ground. The urgency for swift action cannot be overstated in the case of malnutrition as it determines the productivity and cognitive abilities for generations to come. The body and the brain develop fastest in the womb and in the first two years of a child’s life. This time period needs to be the absolute focus of Indian policymakers.

Analysis

2018 In Retrospect: Permanent peace eludes Jammu and Kashmir, as it has for last 30 years

Published

on

Jammu/Srinagar, Dec 17: It’s been a fairly turbulent year in the state, both security-wise and politically. It saw more violence compared to last year, even though the security forces killed many militants, including some top commanders of militant outfits.

There were 587 incidents of violence during 2018 compared to 329 last year. Official figures say 240 militants were killed during the year against 200 last year.

Casualties among civilians and the security forces have also been comparatively higher. Thirty-seven civilians and 86 security men were killed in 2018 against 36 civilians and 74 security personnel killed last year.

Permanent peace eluded the state in 2018 as it has during more than 30-years of strife.

According to senior intelligence officers, there are still around 240 militants, including foreigners, who are active in the state.

“The number keeps on varying depending upon infiltration of new militants from across the line of control (LoC) and recruitment of local youth into militant ranks”, said a senior intelligence officer.

Summing up the security scenario, Lieutenant General A.K. Bhatt, who commands the Srinagar-headquartered 15 corps of the Indian Army and is the senior-most army officer in the Valley, said: “The security forces have a limited role in controlling the ground situation in the state. The final solution has to be political.”

On the political front, there was a dramatic turn in June when the right-wing Bharatiya Janata Party (BJP) suddenly announced in New Delhi that it was withdrawing from the ruling coalition in the state, headed by the Peoples Democratic Party.

The announcement was not unexpected as the two ideologically opposed parties were ruling the state for four years through an uneasy arrangement that appeared brittle from day one since the late Mufti Muhammad Sayeed announced it in 2015.

With the withdrawal of BJP support, the Mehbooba Mufti-led coalition fell and Governor N.N.Vohra dismissed the government, even though the state assembly was kept in suspended animation for any future alliance to stake claim to power.

Vohra was subsequently replaced by Satya Pal Malik who became the first politician to be made the state governor. As compared to his predecessor, Malik chose to speak to media as often as he could to put forth his view point, sometimes to the embarrassment of both New Delhi and Malik himself.

The fist thing the new governor did was to announce local urban bodies and panchayat elections in the state. Both these democratic processes were concluded peacefully throughout the state and their conduct is considered a feather in the administration’s cap as the elected government had been shying away from conducting the elections.

With the imposition of governor’s rule, the PDP started suffering desertions as some of its dissident legislators launched an open rebellion against the party leadership. In the forefront of the dissidents was senior Shia leader and former state minister Imran Ansari who finally joined the Peoples Conference (PC) headed by Sajad Lone, himself a former minister in the PDP-BJP coalition government.

Sajad’s PC started emerging as the possible Third Front that could, in future, pose a challenge to both the PDP and the regional National Conference (NC) headed by Farooq Abdullah.

Ever since the elected government fell, rumours started doing the rounds in the state that dissidents in the PDP, the NC and even the Congress party were waiting in wings to join the Third Front. The visit of BJP general secretary Ram Madhav to the state and his meetings with Sajad Lone and dissidents kept fuelling these rumours even when Madhav said there was no immediate move to form a government in the state.

The fear of their flock being poached pushed the arch rivals, the NC and the PDP, come close to each other. In a surprise move, Altaf Bukhari, senior PDP leader and former minister emerged as the contender for the Chief Minister’s post with outside support by the NC. With the NC’s 15 and the PDP’s 29 seats, the two parties hold a simple majority in the 87-member state assembly.

The NC and the PDP said they had decided to sink their differences to protect the special status of the state as article 35-A and other constitutional provisions were being challenged to dilute this.

There were also reports that the Congress was in the loop to shoot down horse-trading in the state. The PDP president, Mehbooba Mufti, sent a fax to the Raj Bhawan seeking an appointment with the Governor to stake claim to power. The fax was never received as the Governor said later the fax operator at the Raj Bhawan was off duty due to a holiday.

Amid claims and counter-claims, Governor Malik, in a dramatic move, dissolved the state assembly on November 21, justifying this by saying that he wanted to “prevent horse-trading”.

The possibility of any dialogue between the centre and the separatist leadership remained a distant possibility during the year. In all likelihood, this will have to wait till a new government takes office at the centre after the 2019 general elections in the country.

Elections to the state assembly are also likely to be held simultaneously with the 2019 Lok Sabha elections around April-May next year.

By Sheikh Qayoom

(Sheikh Qayoom can be contacted at [email protected])

 

Continue Reading

Analysis

Agrarian crisis dominates, set to influence 2019 general elections – 2018 In Retrospect

At the same rally, Congress President Rahul Gandhi had said: “The voice that is reverberating now across the country is of the farmers who are in deep distress and crisis.”

Published

on

New Delhi, Dec 17 : Agrarian crisis emerged as a major political concern in 2018, fuelled mainly by a fall in crop prices and a poor procurement mechanism which will provide opposition parties a common ground to rally against the BJP ahead of the next year’s general elections.

The anger brewing against the perceived “anti-farm policies” of the government could be measured by the poor performance of the BJP in the rural parts of Hindi heartland states in the just-concluded Assembly elections, that saw the BJP ousted from power in all three states.

In past one year, the national capital alone saw at least five major rallies of farmers, despite the BJP-government coming up with a new price-fixation formula and a score of schemes to impress the tillers of the soil.

The police firing in Madhya Pradesh’s Mandsaur last year that led to the death of six farmers, sparked agitations throughout the country over rural distress, which snowballed into a major political and social issue this year. The simmering discontent among farmers gained political traction in 2018.

Various opposition parties have been raising their voices against different issues to suit their electoral needs but they showed unanimity in expressing their solidarity with the demands for better crop remuneration and farm loan waivers during the November 30 farmers’ rally in the capital.

At the same rally, Congress President Rahul Gandhi had said: “The voice that is reverberating now across the country is of the farmers who are in deep distress and crisis.”

For the first time, the 2019 Lok Sabha elections will be fought on issues revolving around rural distress, said Yogendra Yadav of Swaraj India, who is credited with bringing over 200 farmers’ outfits under one banner — the All India Kisan Sangharsh Coordination Committee (AIKSCC).

“There has always been agrarian distress in the country. However, it never got an occasion to become a principal factor in the elections. The BJP’s defeat in the Assembly polls, coupled with the newly-achieved unity among farmers, has ensured that farm distress would take a centre stage in the 2019 elections,” Yadav told IANS.

He termed the BJP regime led by Prime Minister Narendra Modi “the most anti-farmer” government in the history of the independent India because of its “unsympathetic” treatment of farmers in the past four-and-a-half years.

Many videos throughout the year went viral on the social media, featuring angry farmers throwing their harvest and milk on the roads in the absence of remunerative prices.

Amid protests, the government increased the Minimum Support Price (MSP) for certain agriculture commodities. However, the farmers found this not at par with their demands and expectations.

Also, poor procurement of commodities owing to inadequate numbers and delay in the opening of purchasing centres by the government agencies forced the farmers to make distress sales.

In the case of vegetables, while the retail prices hovered between Rs 20-30 in major cities, the prices received by farmers for semi-perishable commodities such as potatoes and onion slumped to Rs 1 per kg.

The Agriculture Ministry seemed “ineffective” to create a redressal mechanism, activists said, though it came up with three procurement plans. Notably, Union Minister and Senior BJP leader Nitin Gadkari had in June this year acknowledged that there was agrarian crisis due to surplus crop output and sought action to address the problem.

And yet, the BJP-government failed to take corrective action by analysing the demand-and-supply situation, said Swabhimani Shetkari Sanghatana leader and Lok Sabha member Raju Shetti, who quit BJP-led National Democratic Alliance (NDA) over farmers issues’ last year.

“The government has been quite aware of the farmers’ issues. However, it did not take required action to ensure remunerative prices for farmers and the procurement of their harvest was ineffective,” Shetti added.

Noted agronomist Ashok Gulati said there was “lack of understanding” and “lack of vision” in the current BJP regime. He said the government did not carry out the required market reforms but resorted to just slogans and announcements.

“Even after the Mandsaur firing episode, the government did not act,” he said.

Any government needs a smart agriculture minister for effective implementation of schemes, he added.

Interestingly, Agriculture Minister Radha Mohan Singh chose to attend a Yoga session with Baba Ramdev in Bihar two days after the Mandsaur firing.

(Saurabh Katkurwar can be contacted at [email protected])

Continue Reading

Analysis

Now comes the hard part for the Congress

The Congress and its president will have to realise that such generalities no longer pay political dividends. The voters, especially the youth, are interested in specifics, including the spelling out of targets.

Published

on

Winning, although narrowly in Rajasthan and Madhya Pradesh, was the easy part for the Congress.

The favourable signals were there from the party’s earlier by-election victories in the two states. But despite the Congress’s latest success, what must be worrying for the party is that it missed losing by a hair’s breadth, given how close the voting percentages were for the two contenders – 39.3 per cent for the Congress in Rajasthan against 38.8 for the Bharatiya Janata Party (BJP) and 40.9 per cent in Madhya Pradesh for the Congress against the BJP’s 41.

What this means for the Congress is that it doesn’t have a moment to lose to show that it can provide better governance than its predecessor. There is no time for the party to bask in the glory of having risen like a Phoenix from the ashes of the 2014 drubbing. It has to hit the ground running, as the phrase goes.

It will not do for the Congress to bank only on populist measure like loan waivers for farmers which are frowned upon by economists as sops which ultimately help neither the farmers nor the agricultural economy. The loan waivers are in line with Sonia Gandhi’s favourite rural employment scheme of the Manmohan Singh government which was of no help to the party in 2014.

Nor will the pursuit of a “soft” Hindutva line to project the Congress as a BJP minus the gau rakshaks be of any help. Instead, the party will have to take definitive steps to demonstrate that it means business in dealing with agrarian distress and unemployment – the two main factors which brought about the BJP’s downfall.

Neither of the two steps will be easy for a state government, especially when there is an unfriendly regime at the centre, waiting to see how it fumbles. But an emphasis on irrigation and on groundwater and surface water management can underline the state government’s serious intent.

An expansion of the formal credit facilities can also reduce the dependence of the farmers on rapacious money-lenders, as can efforts to ensure that the routine subsidies are not misappropriated by the richer farmers.

Similarly, joblessness can be partly alleviated by helping in the growth of small and medium businesses in states which haven’t yet been able to shed the damaging BIMARU tag of being “sick” where the social and economic indicators are concerned.

But, in addition to such initiatives which are within the capabilities of the state governments, it is time that the Congress at the national level outlines its broad economic vision, which has been hazy so far as was evident from Rahul Gandhi’s reluctance to specify what he means when he talks of supporting farmers, creating jobs and extending health care, as he did at the London School of Economics last summer.

The Congress and its president will have to realise that such generalities no longer pay political dividends. The voters, especially the youth, are interested in specifics, including the spelling out of targets.

Since the problem with the Congress is that it has been unable to make up its mind between populist and pro-market policies, it appears to be suspended in midair where economics is concerned with no one knowing what to expect from a Congress government – a return to Manmohan Singh’s economic reforms or to Sonia Gandhi’s focus on freebees.

So far, the Congress governments in Punjab and Karnataka have been run-of-the-mill ones with little to show them as result-oriented, especially in the matter of bolstering the economy.

But, now that three more states have come under the party’s aegis, there has to be greater focus in its policies instead of a recourse to homilies.

For Rahul Gandhi, the unambiguous projection of an economic direction in the run-up to the next general election will be a bigger test than containing the Congress’ age-old malady of internal factionalism dating to the Tilak-Gokhale split of 1907.

If Narendra Modi is perceived to be faltering, it is because he tried to tackle the country’s economic ills with patchwork repairs like opening myriad bank accounts, providing direct cash transfers for cooking gas cylinders, extending rural electrification and undertaking faster highway construction. But he failed in carrying out what are called “big bang” reforms to rejuvenate the economy, which was the expectation behind his 2014 success.

If Rahul Gandhi, too, is found to be following in the BJP’s footsteps not only in pursuing “soft” Hindutva, but also in the economic field, the unforgiving people of India, who are increasingly becoming impatient for quick results, will have no hesitation in dumping the Congress.

The Congress president’s problem is that he will have carry with him his allies in the mahagathbandhan – if and when the grand alliance is formed – and so he cannot make unilateral announcements on key issues.

But he must remember that the eagerness with which many of them court foreign investors shows that the earlier aversion of the average politician to capitalism is dying out.

Rahul Gandhi will have to state whether he shares their views or still considers himself to be a foot soldier of the Niyamgiri tribals of Odisha who ensured the eviction of investors from their sacred hills.

(Amulya Ganguli is a political analyst. The views expressed are personal. He can be reached at [email protected])

Continue Reading
Advertisement

Most Popular