Hungry children failed by state and market

This is a week of good news and bad. The good news is that Goldman Sachs thinks the Indian economy is growing even faster than previously expected:

India could overtake Britain and have the world’s fifth largest economy within a decade as the country’s growth accelerates, a new report says… By 2050 India’s economy could be larger even than America’s, only China’s will be bigger, the bank predicts. [Link]

The bad news is that child malnutrition rates are still startling high in India. This week the PM felt a need to deal out thapars:

Our prevalent rate of under-nutrition in the 0-6 age group remains one of the highest in the world,” Mr Singh said. “These are startling figures and the situation calls for urgent action.” [Link]

The situation remains astonishingly dire:

Last year the UN children’s agency, Unicef, said that the average malnutrition rate in some Indian states – such as densely populated Uttar Pradesh – was 40%. That is higher than sub-Saharan Africa where it is around 30%, Unicef said. [Link]

… Unicef report said half of the world’s under-nourished children live in South Asia….”South Asia has higher levels of child under-nutrition than Sub-Saharan Africa, but Sub-Saharan Africa has higher rates of child mortality…” [Link]

Most striking is the fact that the economic growth of the past 15 years hasn’t necessarily translated into better child nutrition, and that malnutrition has actually risen in some places:

A recent health ministry survey said that the number of undernourished children below the age of three had actually risen in some states since the late 1990s, despite higher incomes and rapid economic growth. [Link]

At the same time, state efforts have also failed to significantly alleviate the problem:

In a strongly-worded letter sent to state chief ministers, Mr Singh said that a massive programme to improve health and nutrition had failed…The prime minister said that the country’s Integrated Child Development Services (ICDS) scheme had not sufficiently dented child malnourishment levels. “There is strong evidence that the programme has not led to any substantial improvement in the nutritional status of children under six,” Mr Singh said, urging strong action… The letter said that the programme had been “poorly implemented”.

The ICDS scheme was established in 1975, and is one of the biggest childcare efforts in the world, providing immunisations, supplementary food and medical check-ups for pregnant women. The scheme is implemented by thousands of state-funded community workers in poor, rural areas with limited or no medical facilities. Correspondents say that efforts to provide nutritious food to children have been constantly marred by corruption in which food intended for the poor is stolen or sold to other people. [Link]

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p>One place to start, according to the UNICEF report, is by improving the status of women:

“the low status of women in South Asian countries and their lack of nutritional knowledge are important determinants of high prevalence of underweight children in the region”. The report also blames “inadequate feeding and caring practices for young children” for the grim situation in South Asian countries. It says it is important that “in the interests of improving child nutrition, women’s status should be raised”. This need is very urgent in South Asia, including India, it adds. [Link]

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p>I’m a pragmatist. Ideology is fine and good, but it doesn’t put food in a baby’s belly at the end of the day. In this case both the state and the market have failed to deliver calories to needy children. Clearly something different needs to be done, something where there is clear accountability and measurement of outcomes. What India’s doing today is simply not good enough.

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81 thoughts on “Hungry children failed by state and market

  1. Quizman — you agree with the facts but not the conclusions, fine. But instead of saying that these are lazy characterizations, break it down – where do you have a problem with the logic. Were you not surprised to see how hight malnutrition was? Were you not surprised to see that economic development has not made a huge dent in it (excuse the double negative but I’m running late) ?

  2. Just asking again if anybody has any links/sources outlining the malnutrition rates state by state?

    http://www.littlemag.com/hunger/shiv.html

    Some 47 per cent of IndiaÂ’s children below the age of three years are malnourished (underweight). In Sub-Saharan Africa, the proportion is, on an average, 30 per cent.”

    Bihar (54 per cent), Orissa (54 per cent) and Madhya Pradesh (55 per cent) report child malnutrition rates higher than the maximum reported in Sub-Saharan Africa by Angola (51 per cent)”

    Manipur reported a per capita income of Rs 8,114 (in 1997-98) and a child malnutrition rate of 28 per cent. Gujarat, on the other hand, reported a per capita income of Rs 16,251 and a child malnutrition rate of 45 per cent.”

    Orissa (50 per cent[or is it 54%?]) and Maharashtra (51 per cent) report similar levels of malnutrition, but MaharashtraÂ’s per capita income is almost three times higher than that of Orissa.”

    “Kerala and Karnataka report similar levels of per capita income. Yet 27 per cent of children under the age of three are malnourished in Kerala. The figure is 44 per cent in Karnataka.”

    “In 1993-94, Tamil Nadu and West Bengal reported similar levels of income poverty (35-36 per cent living below the poverty line), and yet in 1998-99, only 37 per cent of Tamil NaduÂ’s children below three years were malnourished as against 49 per cent in West Bengal

    Haryana (35 per cent) and Assam (36 per cent) reported similar levels of child malnutrition despite the fact that in 1993-94, only 25 per cent of HaryanaÂ’s population lived below the poverty line as against 41 per cent in Assam.”

    Note that Gujarat and Maharashtra have very high malnutrition rates (so much for the trickle down effect).While Kerala and Manipur have the lowest rates of malnutrition among the states mentioned. I expect that Punjab and Kashmir must also have malnutrition rates lower than the Indian average.

  3. i’m wondering what the scale is used to measure malnutrition when comparing the data above. i was looking to find the details of how they determined the % but couldnt find anything. my biais is that the scales/ methods are different when comparing africa and india numbers. thresholds indicating malnutrition can be set differently. i am not saying that children aren’t malnourished in india, but i think the info needs to be assessed.

    one thing that is very different in approaching food distribution between african countries and india is the quality of food… this may have been mentioned already. the fact is that there isn’t enough to go around, so the servings people really need will never get delivered. therefore they need to distribute fortified foods, which deliver better calories and nutrients per serving. this does happen in some places in africa, i have not come across this much in india. india HAS the technology and the know-how to deliver this, but i am not aware that such fortified foods (milk, grains, potatoes, nutrition powders being key) are being produced or distributed at the scope required.

    the inaction and corruption at state and downstream levels are major issues as mentioned already… and for those who see it there is a sense of apathy and ‘what’s going to happen even if we try’. where lies the responsibility of the citizens in questioning this, esp among those that are far above the poverty line. no one really addresses specific issues as far as i can tell from local news programs, it’s basically the goverment vs social sector. and those who aren’t affected just go about their own business.

    providing food and resources is an imminent answer, but not a permanent one… systems still need to be implemented to provide financial opportunity and independance. i find that lack of consistency in overseeing program progress is a problem here… suggestions have been made by governments and money has been provided but the authorities don’t follow up or account for anything. the cycle keeps continuing. i think proper regulating authorities/ systems that mediate between government and citizens, holding them both accountable, need to be created

  4. If almost 50% of the kids are mal-nourished in India, than how come the “Indian”s are genetically predisposed to have coronary heart disease?? Ok, I am being coy. Main point is that I disagree with the “scientific studies” in the west that proclaim “Indians are predisposed to heart disease”… Well, 50% of these “Indians” have other kind of worries in life :-) Again main point is that “genetic predisposition” is a bunch of bullshit masquerading as science. Besides it only applies to the tiny fraction of a group called “Indians”.

  5. If almost 50% of the kids are mal-nourished in India, than how come the “Indian”s are genetically predisposed to have coronary heart disease?? Ok, I am being coy. Main point is that I disagree with the “scientific studies” in the west that proclaim “Indians are predisposed to heart disease”… Well, 50% of these “Indians” have other kind of worries in life :-) Again main point is that “genetic predisposition” is a bunch of bullshit masquerading as science. Besides it only applies to the tiny fraction of a group called “Indians”.

    These are not mutually exclusive. Look at the U.S., where lower income people generally eat higher fat, less nutritious food. If everyone is eating food steeped in ghee with rice, that’s not going to provide a lot of nutritional value, but it will up your chances for other cardiovascular diseases. But also, what does this have to do with feeding malnourished children!?

    As far as market liberalization goes, I honestly don’t see how that could help anything at all. The market, by definition, assumes that some will “win” and some will “lose.” There are not many equilibrium solutions where demand is fully satisfied. I think Saheli summed it up best – it’s not a useful model/ideal, and there are other major factors going into this. As was also mentioned, Sen has done extensive coverage on the “man made” drivers of famine. There is more than enough food to feed the hungry, we simply do not choose to do it. Studies have shown that this kind of disregard for child health not only leads to high levels of child mortality (slow starvation, as I think others mentioned), but it also takes away from a child’s capacity to gain human capital. Talk about furthering (one aspect of) a circle of poverty.

  6. Then there’s that little matter of political will. India could feed all its children if it really wanted to, just as every American could have government-sponsored health insurance. No one likes poor people, they don’t matter, and India is no different from anywhere else in the world.

  7. Ennis,

    I haven’t had the time to read through all the comments, so I might be repeating what others have said already — it’s a mistake to blame the market because the market has not been given a chance. Although food production appears to be in control of small farmers, a lot of price controls and subsidies are in effect and there’s heavy distortion. The ration depots run by the state for food distribtion are a huge failure and they adversely affects distribution. The production and distribution of electricity( a lot of farming is electricity intensive) is still under state control and the populist parties come up with schemes like free power to farmers and low-income population and then failing to deliver it. Case in point is the government of Andhra Pradesh where the congress party promised free power to come in to the government and now struggling to meet the demand. All the growth you notice in India is predominantly in the sectors where the markets have been given somewhat a free reign. The telecom sector, for example, reached the poor amazingly well in very little time of opening up. I agree with you that the state has failed in feeding children( or for that matter everybody) for a number of years, but the markets are still waiting to get there.

  8. ut instead of saying that these are lazy characterizations, break it down -

    I did, in my first comment. As I mentioned, your statement “In this case both the state and the market have failed to deliver calories to needy children.” was not true, since both have in certain segments. I also mentioned that poorest segments of society in India are still under license Raj. Ergo, the market hasn’t reached them. This is especially true of farmers. As we all know, farmers cannot sell their land for commercial purposes (can sell for agro purposes to individual farmers). However, the govt can usurp their land and sell it to companies. Thus, leaving the poorest sections marginalized and displaced.

    My point was that we cannot make a global claim about “state” or “market” and link it to malnutrition in India. We have to break it down to regions, segments, religions, and so on ad infinitum.

    There is also a personal responsibility aspect that bears consideration. I’m sure you saw Oprah’s Roots last night, where individuals went above and beyond limitations imposed by the state and the market.

  9. As I mentioned, your statement “In this case both the state and the market have failed to deliver calories to needy children.” was not true, since both have in certain segments.

    Half of indian children are starving and you have the nerve to claim that the state and the market have worked “in certain segments”?? I guess that makes India a “shining” success to your ilk. In normal nations such a sorry state of affairs would be considered a crisis. But not in callous India. Its too “darn complicated” for indians to solve the chronic hunger problem, says you!

    The states with the most entrepreneurs/capitalists, Gujarat and Maharashtra, have 45% and 51% malnutrition rates respectively. OTOH Manipur and Kerala, which aren’t home to that many baniyas, have rates of 28% and 27%. What conclusion do you draw from that?

  10. i’m wondering what the scale is used to measure malnutrition when comparing the data above. i was looking to find the details of how they determined the % but couldnt find anything. my biais is that the scales/ methods are different when comparing africa and india numbers. thresholds indicating malnutrition can be set differently. i am not saying that children aren’t malnourished in india, but i think the info needs to be assessed.

    http://www.littlemag.com/hunger/shiv.html

    “It was argued that biologically and genetically, Indian children do not normally grow as fast or as large as children in other countries. This is simply not true. Extensive studies by the Nutrition Foundation of India have established that global standards of height and weight apply to all Indian children as well. And the growth patterns of Indian children who are well-fed and well looked after are similar to those of adequately nourished children in other parts of the world, no matter where they are born –– in New York, New Delhi or New Zealand.”

  11. I haven’t had the time to read through all the comments, so I might be repeating what others have said already — it’s a mistake to blame the market because the market has not been given a chance. Although food production appears to be in control of small farmers, a lot of price controls and subsidies are in effect and there’s heavy distortion.

    Following that logic, could the market EVER be “given a chance” so long as an elected government is involved? Price controls and subsidies enjoy tremendous popularity among first world nations as well.

  12. I also mentioned that poorest segments of society in India are still under license Raj. Ergo, the market hasn’t reached them. This is especially true of farmers. As we all know, farmers cannot sell their land for commercial purposes (can sell for agro purposes to individual farmers). However, the govt can usurp their land and sell it to companies. Thus, leaving the poorest sections marginalized and displaced.

    True, but in plenty of other ways, their lives have been changed by liberalization in significant ways. In any case, the bigger point is that GDP increase across India has not been sufficient to alleviate dire malnutrition.

    My point was that we cannot make a global claim about “state” or “market” and link it to malnutrition in India. We have to break it down to regions, segments, religions, and so on ad infinitum.

    I linked to state by state analyses in the comments. Again, it’s still noteworthy that such major transformations have been unleashed in India’s economy and yet the aggregate numbers remain relatively poor. Breaking it down is helpful, but is hardly a whole answer especially since the richer states don’t have less malnutrition than the poorer ones.

    There is also a personal responsibility aspect that bears consideration. I’m sure you saw Oprah’s Roots last night, where individuals went above and beyond limitations imposed by the state and the market.

    Sure. But when we’re talking about that many numbers, it’s not likely to be an individual issue.

  13. Half of indian children are starving and you have the nerve to claim that the state and the market have worked “in certain segments”??

    Assuming children living below poverty levels are the ones left behind. 24%(22% from todays Dr. Kalams Republic day speech) of Indian population are Below Poverty Line. And around 50% are children. That would be 12% are children. Of that 50% are malnourished. Which is 6% of the population. So are you telling, the other 6% were not fed by the government or NGOs?

  14. Doordarshan,

    Fine, shed your tears. These problems cannot be solved at a marco level with grandiose 5 or 10 year plans or slogans. There is no universal panacea to such issues. The lesson that we learn is to find out why the state or the private sector have succeeded in certain segments and try to replicate those in other areas – if applicable. Else, a creative solution needs to be created specifically for that area/community/ etc.

    Making normative statements that the “state has failed” or that the “market has failed” (within this context) just shows intellectual laziness. Think of it this way; if a doctor gives the same medicine to 6 patients and 3 of them get better, he has to examine what was it about the 3 successes and the 3 failures that contributed to the %age of success of the medicine. Is there some other condition that was specific to each of the 3 failures that need to be rectified, to living conditions, to eating habits etc. What you’re saying is that the medicine failed! Let us throw it away. That ensures that the 3 guys who got better get shafted. [It is akin to the idiot above who blamed it all on Hinduism.]

    India’s population increased from roughly 300 million to 1 billion in 60 years. Life expectancy has increased across the board (from roughly 32 from 1820 to 1947, t went about 60 in 2000). How did that happen? What can be done in those regions which fall short of the average? etc. So it was not like 100% of Indian govt workers are corrupt or that the entire private sector is ruthless. Clearly, some folks in some places got it right.

    Here’s an interesting stat:

    Dis-aggregation of underweight statistics (NFHS-II) by socioeconomic and demographic group reveals that weight-for-age underweight prevalence is higher in rural areas (50 percent) than in urban areas (38 percent); higher among girls (48.9 percent) than among boys (45.5 percent); higher among scheduled castes (53.2 percent) and scheduled tribes (56.2 percent) than among other castes (44.1 percent).

    There is also large inter-state variation in patterns and trends in underweight. In six States, at least one in two children are still underweight, namely Maharashtra, Orissa, Bihar, Madhya Pradesh, Uttar Pradesh, and Rajasthan. The four latter states account for more than 43 percent of all underweight children in India.

    ==

    See what I mean by regional trends etc?

    Yes, I too feel sorry for our malnourished brethren, which is why I feel that this has to be taken seriously by intellectuals.

  15. You said:

    Making normative statements that the “state has failed” or that the “market has failed” (within this context) just shows intellectual laziness.

    But that wording comes from the PM:

    In a strongly-worded letter sent to state chief ministers, Mr Singh said that a massive programme to improve health and nutrition had failed…The prime minister said that the country’s Integrated Child Development Services (ICDS) scheme had not sufficiently dented child malnourishment levels. “There is strong evidence that the programme has not led to any substantial improvement in the nutritional status of children under six,” Mr Singh said, urging strong action

    Is he lazy too? I realize that “failed” is not a quote from him but from the BBC, but he’s staying that the programme has not worked, and it was the major state effort.

    Seems like the state is failing to me.

  16. Quizman,

    I would like to invite you to become chief economics adviser to the new Normaltarian party, where rational thought and analysis actually trump slogans and emotional appeals.

    Gazsi

  17. Ennis,

    That’s my point. The PM spoke specifically of children under six with regard to the ICDS programme. In fact, I have linked to that report in my previous post to cite regional stats.

    Well, I’ll concede that the failure of ICDS is synonymous with the failure of the state. But somehow, I get the feeling that I am taking the easy way out. [Possibly, it is the engineer in me who likes to view defect-counts rather than talk about macro failures. :-) ]

  18. Amartya Sen went ballistic about the pathetic malnutrition numbers which in turn incited the PM to speak out on it – ultimately its an embarassment for his UPA government, which is holding the baton at the moment. Unfortunately, other anti-poor schemes floated by Congress will likely go down to corruption to.

    I am told that several thousand non-existent people have been conjured up to receive wages from the 100-day guaranteed work scheme, for the benefit of India’s upstanding bureacrats, no doubt.

    Its pro-labor union stance has the effect of limiting hirings in the ‘organized’ sector, which keeps business small, so as to avoid grasp by the multi-tentacled state monster, which leads to abuse because workers (90% of whom are in the unorganized sector) have little protection. And that limits tax collections.

    The poor are subsidizing the rich’s consumption of water as well. The water delivery stystem in the metros is pathetic, and the poor wind up paying money to the water mafia to obtain their daily fill, while the rich pay subsidized rates to a failed system whose workers enjoy maximum union protection!?

    And then its leaders look for the jobs which give them maximum leverage as crony rajas. Why do you think Lalu wanted railways? Because he has thousands of jobs to dole out. He, who the All-India Yadav Samaj believes (along with Mulayam Singh Yadav) is an incarnation of Lord Krishna. He too believes it, and is a pious cow-protecting vegetarian as a result.

    And its intellectuals go on about “neo-liberalism” … hehe. I have a feeling the South (well some southern states)will clean up before the North – though cronyism – by world standards – is bad there too.

  19. Fine, shed your tears. These problems cannot be solved at a marco level with grandiose 5 or 10 year plans or slogans. There is no universal panacea to such issues. The lesson that we learn is to find out why the state or the private sector have succeeded in certain segments and try to replicate those in other areas – if applicable. Else, a creative solution needs to be created specifically for that area/community/ etc.

    These problems have already been solved by many other nations. What resources are indians lacking that make this problem so “darn complicated” to you? Are indians just too dumb or what?

    Making normative statements that the “state has failed” or that the “market has failed” (within this context) just shows intellectual laziness.

    You just refuse to accept that India’s massive hunger problem is a national failure.

    So it was not like 100% of Indian govt workers are corrupt or that the entire private sector is ruthless. Clearly, some folks in some places got it right.

    You seem to think that half of indian children starving is not a national failure. That says a lot about you. It should be considered a national crisis.

    Its people like you, making excuses, the chalta hai attitude, that are the root cause of India’s problems. Population has increased worldwide. Why are other nations able to feed their children but not India? Your reasoning seems to be that half of indian children are not starving, so India has not been a failure. That is so….contemptible.

    See what I mean by regional trends etc?

    All regions of India are severely malnourished. Some more than others. Why are Gujarat and Maharashtra more malnourished than Manipur and Kerala?

  20. You seem to think that half of indian children starving is not a national failure. That says a lot about you. It should be considered a national crisis.

    I would really like to see some proof that half of Indian children are starving. Which report gives this information.

  21. The numbers are from UNICEF:

    % of under-fives (1996-2005*) suffering from: underweight, moderate & severe: 47 % of under-fives (1996-2005*) suffering from: underweight, severe: 18 % of under-fives (1996-2005*) suffering from: wasting, moderate & severe: 16 % of under-fives (1996-2005*) suffering from: stunting, moderate & severe: 46 [Link]

    I can’t find the report – it came out last year. I suspect the GOI also has similar numbers of its own, otherwise they would be disagreeing.

  22. Doordarshan: Its people like you, making excuses, the chalta hai attitude, that are the root cause of India’s problems. Population has increased worldwide. Why are other nations able to feed their children but not India? Your reasoning seems to be that half of indian children are not starving, so India has not been a failure. That is so….contemptible.

    Where did that come from? You don’t know me at all.

    My angst is because of the fact that I have spent many hours working on grassroots education as a volunteer with a NGO. I’ve realized that every school in every village has to be tackled differently. That there is no magic wand, as you seem to want. So fine, you feel sorry. You get angry and shout slogans and accuse others like me of making excuses. I haven’t seen any creative solutions from you on this forum either.

  23. Its people like you, making excuses, the chalta hai attitude, that are the root cause of India’s problems. Population has increased worldwide. Why are other nations able to feed their children but not India? Your reasoning seems to be that half of indian children are not starving, so India has not been a failure. That is so….contemptible.

    Doordarshan is right though, India has totally failed in this regard to alleviate chronic hunger and the worst forms of poverty. However, he is totally wrong in assigning the blame . . . just like a typical lefty. Like the CCR song “FOrtunate Son” . . . and when you ask them, how much should we give, oooh the only answer is more MORE MORE! his/her solution will only be more communism/socialism, ensuring another good 50 years of economic and social stagnation. And then, when things get worse, he will have more talking points to blame everything on casteism and markets and capitalism and not enough collectivization.

  24. Where did that come from? You don’t know me at all

    That came from your opinions expressed here, where else? Why do we need to know you personally to know where you stand on this issue? Thats just silly.

    I haven’t seen any creative solutions from you on this forum either.

    You seem to be more interested in excuses than in creative solutions. A solution to this crime against humanity is too “darn complicated” for indians, according to you. That sort of attitude is the reason why India remains so hungry and impoverished. What “creative solution” to the distribution of food, water, electricity etc to all citizens have other nations successfully employed that India is unable to duplicate? This is not rocket science. Its a failure of will.

    India has totally failed in this regard to alleviate chronic hunger and the worst forms of poverty. However, he is totally wrong in assigning the blame . . . just like a typical lefty.

    At least you recognize that India has failed. So many indians just refuse to accept that. Whats “typical lefty” about blaming the corrupt, incompetent government, the cruel, heartless culture, the apathetic media and so on about this failure?

    Since you are a proud right-winger explain why right wing and entrepreneurial Gujarat is more malnourished than left wing Kerala despite being far more industrialized?

    The stubborn ideologues of both left and right are wrong. Every developed nation on earth has found some balance between capitalism and socialism. Every civilized nation has a safety net for its citizens. You dont starve in Japan, Sweden or America if you you lose your job. India to its shame abandons its citizens to hunger, beggary, illiteracy, lack of sanitation, clean water and so on. Thats criminal negligence. It makes India a failed state.

  25. Break it up guys. Focus on your disagreements, but don’t make it personal. And that goes for both of you, Quizman too.

  26. You seem to think that half of indian children starving is not a national failure. That says a lot about you. It should be considered a national crisis.
    I would really like to see some proof that half of Indian children are starving. Which report gives this information.

    I only see statistics for children under 5. Not half the children in India.

  27. I only see statistics for children under 5. Not half the children in India.

    I think the statement is usually that half the children under 5 or under 6 in India are malnourished. That’s the age at which it tends to be measured. You’re right, perhaps they’re magically more nourished by 12, I dunno.