Hunger and malnutrition in “Vibrant Gujarat”

The Prime Minister’s home state Gujarat boasts of excellent economic growth, making it one of the top ten Indian states with highest per capita income (Rs.1,06,831 in 2013-14 : Ministry of Statistics and Programme Implementation) yet malnutrition and hunger are rampant within its borders. Surprisingly, the hunger levels in Gujarat are higher than those of Uttar Pradesh, which falls in the bottom five states with lowest per capita income. Anil B Deolalikar, economist at the University of California, Riverside and lead author of the International Food Policy Research Institute’s India Hunger Index, in his Gujarat paper mentions that the state has not only high levels of hunger but also is among the lowest beneficiaries from a national rural jobs programme.

Narendra Modi’s ‘vibrant Gujarat’ has a dark side.  That of children with stunted bodies and hungry stomachs. Out of the state’s total population of 60.4 million people, 24.6% are facing hunger and malnutrition. Gujarat’s figure of “severely malnourished” children (4.56%) exceeds the national average (3.33%). The state’s tribal community is worse off. Around 90% of the tribal population (8.9 million) lives in rural areas, with an estimated 35% (about one-third) tribals living below the national poverty line. Living in extreme poverty, 59.8% tribal children under five years have stunted growth and 31% are severely stunted (Census 2011, NSSO). Gujarat’s tribal community is not only in the bottom ring of development, it is also the most nutritionally deprived social group.

Millennium Development Goals and Gujarat

The United Nations Development Programme’s (UNDP) Millennium Development Goals, which were pledged by 189 nations across the globe in 2000, were framed ‘to free people from extreme poverty and multiple deprivations’. The eight goals were to be achieved by 2015. However, in 2010, the participating countries recommitted themselves to the mission and worked for an accelerated progress towards achieving the MDG. Among the eight goals are ‘eradication of extreme hunger and poverty’ and ‘reducing child mortality’.

Based on the data compiled by the Social Statistics Division, Ministry of Statistics and Programme Implementation, India Country Report 2015 shows the true picture of Modi’s Gujarat.

Under 5 mortality rate (U5MR)

The report found that among the rich states, Gujarat’s performance in achieving the MDGs for bringing down morality rate of under-five (U5MR) to the MDG target of the United Nations (38 per live births till 2015), has been the worst. The states of Delhi, Maharashtra Andhra Pradesh, Jammu & Kashmir, Himachal Pradesh, Tamil Nadu, Karnataka, Kerala, West Bengal and Punjab have already crossed the national level target of U5MR. Gujarat on the other hand, is lagging behind.

The study also pointed out that with their current rate, districts in Gujarat like Patan, Sabarkantha, Panchmahal, will not be able to achieve the MGD over five years. There is a sharp variation between urban and rural Gujarat. The urban Gujarat has U5MR of 28 while the rural has 53. Other states which have a rural – urban gap in IMR is highest in Assam (Rural IMR- 56, Urban IMR -32), followed by Rajasthan (Rural IMR- 51, Urban IMR -30), Gujarat (Rural IMR- 43, Urban IMR -22) and Madhya Pradesh (Rural IMR- 57, Urban IMR -37).

Six districts in the state are amongst 42 worst-performing districts by registering a decline of two or less U5MR. The tribal sub-district of Dahod has the highest U5MR in Gujarat at 83.6 U5MR (in every 1000 births).

Losing fight against infant mortality rate (IMR)

UNICEF data shows that Gujarat’s rural IMR ranking went down from 11th position in 2004 to 12th position in 2012 among 20 major states of the country. IMR, counted per thousand live births, is the number of children dying before the age of one. The MDG target for India was 27 infant deaths per 1000 live births by 2015, which till 2013 was at 40. At IMR of 36, Gujarat is way behind other big states like Kerala (IMR-12), Maharashtra (IMR-24), Punjab (IMR-26), Karnataka-31 and Delhi (IMR-24).

The rural –urban gap in IMR is significant in Gujarat, implying higher incidence of poverty and malnutrition in rural areas. The data provided in the India Country Report 2015 by the Sample Registration System, Office of Registrar General of India, shows that Gujarat (Rural IMR- 43, Urban IMR -22) is counted among the states with high urban-rural gap. The rural-urban gap in IMR is highest in Assam (Rural IMR- 56, Urban IMR -32), followed by Rajasthan (Rural IMR- 51, Urban IMR -30) and Madhya Pradesh (Rural IMR- 57, Urban IMR -37).

In a comprehensive nutrition survey carried out by the International Institute for Population Sciences, Mumbai, along with the state government, it was found that among the age 12-23 months, only 83.2% children were fully immunized. The survey, however did not cover the most backward districts of Gujarat, including the Dangs and Dahod. Both nutritional and basic health services were out of reach in the poverty stricken areas.

Failure of welfare schemes

In Gujarat, every third child is underweight. The state ranked 20th in the malnutrition scale in 2012, with Uttarakhand, Sikkim, Haryana and others dong better in reducing malnutrition levels between 2007 and 2011. The levels of undernourishment among children of the state – especially those living in the tribal belt – is as high as 94 percent.

The Comptroller and Auditor General of India reported numerous loopholes in the implementation of Integrated Child Development Scheme (ICDS) in aanganwadis.

Malnutrition levels in some tribal villages is as high as 94% and the aanganwadis are partially to be blamed for the melancholy figures. Children in these villages are not using the mid-day meal programme. The CAG reported that almost 28% aanganwadi centres do not provide regular health check-ups. Lack of basic amnesties at the aanganwadis is a major deterrent preventing children from going to school. The food supplied under the ICDS scheme was not reaching the aanganwadis but was being fed to the cattle.

As the lies around the shining Gujarat story became bigger, more truth came forward about the grim reality of Modi’s state. In reply to a right to information (RTI) application filed by activist Mujahid Nafees in 2014, it was found that as many as 15,016 (30%) aanganwadi centres did not have toilet facilities and 15,695 (33%) aanganwadi centres did not have water facility. Further, as many as 1,961 posts of aanganwadi workers and 3,096 posts of aanganwadi helpers were vacant; 357 posts of child development programme officer (CDPO) and assistant CDPO were vacant out of 572 sanctioned posts, and 346 posts of supervisors were vacant out of 2,222 sanctioned posts.

In 2009, the government revised the nutritional value of the food given through ICDS. Aanganwadis were instructed to calculate the nutritional value of the food and disburse accordingly. It was recommended that under the ICDS, children in the age group of 3-6 years must be entitled to food supplement of 500 calories of energy and 12-15 gm of protein per child per day in the form of take home ration (THR). Yet children in Gujarat lag behind in growth and development. 

Another study conducted by at by the Department of Community Medicine, Govt. Medical College, Rajkot (RK Chudasama, AM Kadri, PB Verma, UV Patel, N Joshi, d Zalavadiya and C Bhola) exposed the sorry state of the state’s aanganwadis centres. The aanganwadis centres are entrusted with the wellbeing of underprivileged children, a duty which most centres have been failing to fulfil.

Titled “Evaluation of Integrated Child Development Services program in Gujarat, India”, the study conducted in 2013 evaluated 60 aanganwadi centres across the state. Many gaps were found in the implementation and coverage of the ICDS. The report stated that supplementary nutrition coverage was reported only in 48.3% in children. Interruption in supply of supplementary nutrition was reported in 61.7% aanganwadi centers. Only 20% centers reported 100% pre-school education coverage among children. Immunization of all children was recorded in only 10% aanganwadi centers, while in 76.7% centers, no such records were available. Regular health checkup of beneficiaries was done in 30% centers. Referral slips were available in 18.3% aanganwadi centers and referral of sick children was done from only 8.3% centers.

Stunted children, not so beauty conscious after all

As children in Gujarat face malnutrition and deprivation and fail to meet their potential for growth and development, Narendra Modi attributed the problem to population (children) being “more beauty conscious than health conscious”.

On the condition of stunting and poor growth of children in Gujarat, UNICEF has noted: “In the area of social development, one of the main challenges faced by the state is the high prevalence of child under nutrition, in addition to a slow reduction in Infant Mortality Rate (IMR).

Failure of child welfare schemes, poverty, due to loss of livelihood, poor re-habitation measures add to the worsening health statistics of Gujarat. Weak governance and negligible accountability, coupled with poor reach and quality of essential foods to remote rural areas is affecting the children during critical period of their lives. Child stunting is one of the biggest threats to growth and development. If Narendra Modi realizes, it is an equal threat to the welfare of the state also, as stunted bodies will grow up with stunted brains and stunted lives.

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