POVERTY: India: Oxfam drive to fight poverty

STAFF REPORTER Guwahati, June 1:

Oxfam, an international confederation of 14 organisations working worldwide to find lasting solutions to poverty and injustice, launched its anti-poverty campaign, Grow, in the state today.
Talking to the media, Oxfam’s national humanitarian hub manager, Zubin Zaman, said the organisation would work for food sovereignty of the small farmers and try to explore the factors that contribute to hike of food prices in Assam, as a part of the campaign.
Oxfam has undertaken sanitation works in disaster-prone areas of Dhemaji, Lakhimpur, Majuli and Morigaon, along with the local NGOs.
Grow, a global campaign, aims to fight poverty in collaboration with governments, companies and international bodies like G20.
In India, the campaign was simultaneously launched today in Guwahati, Hyderabad, Lucknow, Mumbai and Patna. Zaman said the campaign has been launched for four years initially.
Oxfam observed that despite Indian economy having grown considerably between 1990 and 2005, the number of hungry people increased by 65 million, more than the total population of France. This was because economic development excluded the rural poor and social protection schemes failed to reach them
“Around 60 years later, unfortunately, hunger and malnutrition remain major issues in India. About 44 per cent of children under the age of five are underweight and 48 per cent are stunted. Because of the country’s large population, India is home to 42 per cent of the world’s underweight children and 31 per cent of stunted children,” Zaman said.
He, however, said the condition of Assam was not as bad as the other states of the country in terms as food availability. However, continuous erosion and population increase point to tough times ahead. Zaman said in the agricultural field, they would give emphasis on research activities in a bid to make farmers dependent on their own seeds rather than imported ones. Besides, they would also examine the role of the imported cost factor in increasing food prices in Assam.
Zaman said Assam would be affected by the imminent global food crisis in the coming days. According to the projection of Oxfam, demand for food will rise by 70 per cent by 2050 globally while food production capacity will steadily decline.

http://www.telegraphindia.com/1110602/jsp/northeast/story_14059288.jsp

POVERTY: India: Unless you are starving you can not be poor

Anuradha Raman


 Nilotpal Baruah

Making Ends Meet The cutoff income (Rs 20 a day) for defining urban poverty won’t get a person a decent meal

In the urban sprawl that is Delhi, as in any other metro in the country, earning no more than Rs 25 per day with a family to support would prove nightmarish. Food and clothes have to be bought, there may be school-going children, colds, fevers or upset stomachs to get treated, someone with a chronic problem needing long-term treatment. Surely, someone living on Rs 25 a day would qualify as poor. But not by the benchmark set by the Planning Commission and the government of India. The urban poor have been defined as earning less than Rs 20 per day, the rural poor as earning Rs 15 per day. Anyone earning even a few rupees more than that does not qualify for a below poverty line (BPL) card and the benefits it confers.



Callous as this may sound, unless you starve and join the swelling ranks of those who live their life on the pavements, begging for a living, you cannot be officially poor. The accompanying chart (above) shows the frugal consumption that can be managed by the ‘officially’ poor. It also indicates that it’s impossible to consume 2,100 calories (the minimum for an adult male in cities) at Rs 20 per day, and 2,400 calories (the minimum for an adult male in villages) at Rs 15 per day. Remember, if a family has to survive on Rs 15 or Rs 20, then what each member consumes will be even lower than what’s indicated in the box. “If the state has its way, you will have to plan in order to be poor,” says Colin Gonsalves, activist and Supreme Court lawyer. “According to the state and the Planning Commission, unless you’re starving, you cannot be poor.”
Last week, the Supreme Court directed the government to take a fresh look at how the poverty line is defined and distribute five million tonnes of foodgrain to the 150 poorest districts. With the Food Security Act still caught in a political quagmire, it has been left to the courts once again to prod the executive into taking the first step towards ensuring that foodgrain reaches the poor.
Additional solicitor-general Mohan Parasaran, who is appearing for the government, says the debate on the poor is being exaggerated by some sections who have been party to every single deliberation on food security. “I think the criticism is unfair as the government is taking steps to make additional allocation of foodgrain to the poor,” he says. “But the states have not lifted the foodgrain to distribute them to their poor.”
Last year, TV footage and media reports showed sackfuls of grain rotting in godowns because it was not distributed. These reports prompted the Supreme Court to intervene. While the states blamed the Centre, the latter tossed the ball back to the states, accusing them of not lifting the stocks on time, rendering the grain unfit for consumption. As rough estimates go, in Punjab and Haryana nearly 61,000 tonnes of foodgrain—which could have fed 120 lakh people for a month—was wasted. It all looked like a cruel joke, for about the same time, the agriculture ministry was talking about record foodgrain procurement in 2010. Even worse was to follow, as the Food Corporation of India suggested the release of foodgrain and an empowered group of ministers rejected the suggestion, leading to speculation that this was because it would have cost the government as much as Rs 5,000 crore in subsidy.
There is, of course, another scary dimension to the food debate, which concerns children. If numbers are anything to go by, the child malnutrition rate in India, according to the National Family Health Survey-3 (2006), is 46 per cent. The under-five mortality rate in India is 74 for every 1,000 births: that’s about 17.8 lakh deaths per year, half of the deaths occurring, that is some 8.8 lakh, due to malnutrition. This roughly translates as 75,000 children dying every month due to malnutrition and an astounding 2,500 child deaths daily. Extrapolating further, more than a hundred children die every hour across the country due to malnutrition.


Rotten Shame File photo of grain spoiling in an FCI godown that set the SC thinking. (Photograph by Prabhjot Singh Gill)

That is why every discussion on social benefits is linked to who constitute the poor. The Alagh committee report of 1979 and the more recent Tendulkar committee report have been used by the government to get a fix on who really is below the poverty line. The estimates are very important for allocation of grain is linked to the number of poor.
Most children’s deaths are due to malnutrition and linked to poverty. One more reason to get poverty figures right.
Till the late 1990s, the public distribution system (PDS) was universal and covered the entire population. It was only after 1997 that the PDS was ‘targeted’ at those below the poverty line. But who are the poor? Three recent panels have come up with figures varying from 36 per cent (Planning Commission, 2004), 37 per cent (the Tendulkar committee, 2004-05) to a high of 77 per cent (the National Commission for Enterprises in the Unorganised Sector, 2008-09). According to many, the government, backed by the Planning Commission, is keen on trimming the food bill to cut subsidies. And this can be achieved only if the percentage of poor is kept at a minimum. It is learnt that the Planning Commission wants it fixed at 27 per cent.
Interestingly, some states—West Bengal, Uttar Pradesh, Orissa and Rajasthan—submitted in their affidavits to the Supreme Court last week that the estimates of poverty arrived at by the Centre were far less than the actual numbers on the ground. They have claimed that nearly 35 per cent of the population is poor. It is no surprise then that given the stakes, the Centre is represented by a phalanx of high-profile lawyers, the attorney-general, solicitor-general and three additional solicitors-generals.
The battle, of course, is far from over. As long as deaths due to malnutrition and starvation occur in the country, no government can bask in the claim that India is a shining economy.
http://www.outlookindia.com/article.aspx?271885

MALNUTRITION: India: As many as 5000 children below age of five die every day in India

Joseph Alexander,  May 06, 2011

As many as 5000 children die in India every day and 1.8 million an year, before they reach the age of five, according to a study by leading NGO World Vision.
The underlying cause of 60 per cent of these deaths is malnutrition and prevalence of underweight among children in India. About a third of India’s children are born already malnourished with low birth weight, about 46 per cent of children under five are underweight, 48 per cent are stunted, 20 per cent are wasted and 70 per cent are anaemic, says the report titled `Breaking barriers to health care for children.’
“Growing inequalities between income and social groups combined with massive shortfalls in primary health care and the rising cost of care is derailing India from achieving the Millennium Development Goals 4 & 5. We are witnessing what could be described as health ‘apartheid’, where families in least-developed states and rural areas are forced to fend with sub-standard and inadequate public health facilities. It is a shameful reality that a child’s chance of survival may depend simply on where they are born,” it says.
Among the 81 per cent of children under six who are in areas covered by an anganwadi centre, only one-third receive some kind of services from the centre. The country’s other large health programme, the National Rural Health Mission (NHRM), has achieved some measure of success. However, it is yet to deliver on the objective of establishing a reliable, fully-functioning public health system for India’s vast rural population, the report points out.
“Over the past 3 decades child deaths have declined, from 116 deaths per 1,000 births in 1990, to 69 in 2008. In the same period infant deaths (during first year of life) declined from 83 to 52 per 1,000 live births. Notwithstanding these gains, India is off-track to meet Millennium Development Goals (MDGs) 4 & 5 which aim to reduce infant deaths by two-thirds and improve maternal health respectively,” the report says.
The other gaps include, infrastructure facilities, equipment and resources, supply of drugs and food supply, facility for children below three years, participation of community, coordination between departments, poor funding, information education and communication etc.
“The reality is public investment in healthcare remains woefully low despite these massive schemes. In 2004 the United Progressive Alliance (UPA) government committed to increased spending to 2-3 per cent of the gross domestic product (GDP) on health by 2012. However current public spending on health care in India is only 1.06 per cent of gross domestic product (GDP) in 2009-10, among the lowest in the world and higher only than Burundi, Myanmar, Pakistan, Sudan, and Cambodia,” it says.
Given the trend towards private care there is a real need to introduce regulations for private practitioners. Many small private providers have poor knowledge and training bases, and sometimes follow harmful and ineffective treatment practices, according to World Vision.
Tackling the major child-killer diseases does not require expensive or high-tech treatments. The chief problem is lack of access to quality primary healthcare where it is most needed. Our focus group discussion with women, community members and service providers, provided insight into the underlying factors influencing the utilization of MNCH services, it said. “There are barriers on the supply side such as physical distance to health facilities, lack of medical personnel and non-availability of drugs,” the report added.
http://www.pharmabiz.com/NewsDetails.aspx?aid=62736&sid=1

MALNUTRITION: India: Widespread malnutrition among children in Bihar

Nishant Sinha,  Apr 17, 2011
PATNA: Bihar accounts for 58 percent malnutrition amongst children which is above the national average of 46 percent. And though the government is committed to provide the best medicare facilities to the people of the state, several factors are responsible for high incidence of malnutrition in children which include non-availability of health services, absence of community workers, low institutional delivery and non-access to cheap medicines.
These apart, cultural practices as early marriage and pregnancy and breastfeeding, too, contribute to higher malnutrition rate in the state.
The state health department has initiated several measures addressing the problem of non-availability of health services, including inadequate number of primary health centres (PHCs), community health centres ( CHCs) and community workers/auxiliary nurse midwives (ANMs)/nurses. The minister concerned as well as the officials had on several occasions admitted the constraints.
http://articles.timesofindia.indiatimes.com/2011-04-17/patna/29427694_1_health-centres-malnutrition-health-services

MALNUTRITION: India: why are nearly half of its children malnourished?

Meg Towle : 3.24.2011
India has more hungry people – and the highest burden of child malnutrition – than any country in the world. The 2010 Global Hunger Index designates national levels of hunger as alarming, and India scores lower than many Sub-Saharan African countries despite having a considerably higher GDP. Madhya Pradesh, the country’s lowest performing state, classifies as extremely alarming and ranks between Ethiopia and Chad internationally.
In our last blog, we discussed how India is expected to miss the MDG hunger target by a considerable margin. By 2015, less than 27% of children under five should be underweight; the last national survey reports that 43% of Indian children are underweight, and some estimates go even higher.





SOURCE: UNICEF 2009, von Grember et al. 2010
How big is India’s nutrition problem?



One third of women are underweight, and over half of married women are anaemic. About 30% of India’s children are born underweight, and by the age of five, 44% are underweight and 48% are stunted due to chronic malnutrition. India accounts for nearly 30% of all global childhood deaths attributed to chronic malnutrition.
The percentage of children under age three who are underweight has virtually not changed between 1998-1999 and 2005-2006, hovering under 50%. The percentage of women who are underweight decreased only marginally, from 36.2% to 33.0%, during the same period. More than 75% of the population lives in households with per capita calorie consumption less than the daily minimum requirements.
During this same time, India has experienced exceptional rates of economic development, edging close to 10% GDP growth. Economic growth has the potential to be nutrition-sensitive if it increases food production, increases access to health services, educates women, reduces fertility rates, and lowers household poverty. While economic growth is required for reducing malnutrition–and no low-income countries have made significant gains in nutrition without relatively rapid growth–economic growth alone is insufficient. India is the glaring example of rapid growth without commensurate gains in nutrition, as reiterated in a recent IFPRI report and study from the Harvard School of Public Health.
When we talk about India’s economic boom, it is necessary to clarify that growth has concentrated in service and technology sectors–and not in the agricultural and manufacturing sectors where the majority of the population (and especially rural India) is economically engaged. Agricultural growth is a critical component of nutrition-sensitive growth, even more so than non-agricultural growth. This is where India poses even more questions. India has had its Green Revolution–the Green Revolution that other regions with significant malnutrition, namely sub-Saharan Africa, have not yet had. Yet malnutrition rates have not changed, and in India regions with higher agricultural productivity and calorie availability also have worse malnutrition. Clearly this points to much deeper issues than food security and availability.

What are some factors of India’s persistent nutrition challenges?
Inadequate purchasing power persists in India due to insufficient employment and livelihood opportunities, land tenure, and growth in non-farm jobs—particularly for scheduled tribe and caste households. Despite India’s early Green Revolution, the agricultural and food sector is stagnating in much of India. India’s rapid urbanization and overcrowding makes households particularly vulnerable to malnutrition by further complicating access to support services, healthcare, clean water, and sanitation.
Gender equity is considered a particularly strong factor in the high rates of maternal and child malnutrition seen in South Asia; women are undervalued in society and “eat least and last.” Restricted access to resources, healthcare services, and decision-making power impacts India’s high incidence of women who are underweight and undernourished, and in turn India’s incredibly high rates of low birth weight babies. Low birth weight has significant implications for survival and an infant’s growth, development, and ability to fight illness. National rates of child anemia, calorie deficiency, and child illness also point to non-optimal feeding practices, which in turn reflects poor maternal nutritional status, economic limitations, sociocultural settings, high fertility rates, limited access to education, and oftentimes mothers’ young ages. Childhood malnutrition, and particularly under the age of two, has significant impact on a child’s lifelong physical growth and cognitive development. It is an incredible generational cycle to break.


Prevalence of stunting, underweight, and wasting in India's children. SOURCE: Paul et al. 2010

India has long suffered without a public health system that reaches the rural masses with high quality, efficient health services. India’s notably low public health expenditures compound issues of access; up to 75% of national health spending is out-of-pocket payments for care in an enormous and unregulated private sector. Childhood illness is a critical factor in nutrition, yet fewer half of Indian children receive qualified health care, and 50% under 23 months are not fully immunized. India does not have an effective strategy for managing malnutrition at community-level, both for prevention and treatment. Services in health, nutrition, and education that do exist have long had limited reach and are of poor quality and not well targeted, which we will discuss more in Part 2 of this post.
These wide factors underscore the fact that undernutrition follows lines of high and rising levels of inequity in the country. Undernutrition is substantially higher in rural than urban areas. Children from scheduled tribes have the poorest nutritional status on nearly every measure, and the highest prevalence of wasting (28%) among under-fives. The proportion of severely underweight children is nearly five times higher among children whose mothers who have no education than mothers who have 12 or more years of school.

What’s the way forward?
Each of this factors are extremely complex – but emphasizes that there are significant social dimensions to nutrition-sensitive growth. We must think beyond pro-poor growth to pro-nutrition growth, where rising incomes and government revenues not only target poverty but improvements in health, infrastructure, and education.
At the same time, it is also important to emphasize that India is an enormous and diverse country, and much of health and nutrition programming is directed at the state level. Growth-nutrition strategies will look very different across the country, and there is much work to be done in thinking through these regional challenges.
http://blogs.ei.columbia.edu/2011/03/24/india-is-booming-so-why-are-nearly-half-of-its-children-malnourished-part-1/