Looking Ahead for a Nutrition-Secure India

Agriculture and food production has a historical association with Asia. The region still stands as a significant contributor to the global food chain. Many rice, cereals, and pulses come from Asia; it is also the largest producer of fresh vegetables globally, mainly from mainland China and India. Irony faced; however, Asia is also a super contributor to malnutrition globally. It is home to 21.8 per cent of stunted children, higher than the global average of 21.3 per cent. The southern part of the region has half of the globally stunted population living there, facing some of the most adverse impacts of under nutrition. 

India, the largest country in South Asia, also has the highest number of stunted and wasted children. Despite the country being at the agricultural forefront, there are 34.7 per cent stunted, and 17.3 per cent wasted children (Global Nutrition Report 2018). Over and above undernutrition, overnutrition is also a rising concern in children and adults. Until 2016, two per cent of children under five were already overweight, and 21 per cent of women were overweight or obese. This double burden of malnutrition is one of the biggest public health challenges facing the country. 

Of many other factors, food and nutrition insecurity appears as a latent cause of undernutrition in India which has severe and long-lasting effects on people\’s health. Data can explain the anthropometric outcomes, but the underlying causes are manifold. In India, the problem starts with the vicious cycles of poverty and socio-cultural inequalities, access to food and dietary needs, poor dietary habits, underregulated policies and public distribution system (PDS) and the harmful effects of climate change on agriculture and biodiversity to name some. 

Low purchasing power parity deprives people of well-balanced nutritional diets. The Covid-19 pandemic has undermined the global progress made in the sector; the World Health Organization (WHO) recently estimated that up to 132 million people might go hungry in 2020, a significant setback to the Sustainable Development Goal (SDG) of attaining Zero Hunger. India is ranked 94th among the 107 countries in the Global Hunger Index, falling under the severe hunger category with a score of 27.2 (Global Hunger Index 2020). This is alarming, indeed. 

Attaining food and nutrition security means making food available, accessible and making the utilisation sufficient and stable by ensuring the physical supply of food, making conducive policies, and promoting sustainable agriculture options. India\’s food policies have primarily focused on increasing agricultural production, reforms to ensure stability in product pricing and subsidising food for the poor through the PDS. There has been an increase in per capita food grains and pulses availability in the past twenty years. The total food grain production increased from 198 million tons to 269 million tons, and the annual growth rate for food grains was 1.6 per cent. However, people\’s availability has not increased at the same levels due to various reasons – population growth, food wastage and losses, and exports, to name some. On average, the rural population allocates about 49 per cent, and the urban population allocates 39 per cent of their monthly expenditure on food in India. Food expenditure is highest among the most deficient 30 per cent who spend more than half of their annual income on food.  

There has also been a much less focus on nutritional security and improving people\’s diets. Food habits and dietary patterns are constantly changing in India. The traditional, staple diets in India are primarily cereal-based, majorly rice and wheat, and lack diversity. Pulses, vegetables, and fruits are also regular parts of diets, but people\’s availability and affordability determine the consumption. Another scenario exists with more people moving to urban areas, the booming culture of eating at restaurants or takeaways. Fast food items are readily available and are cheaper, and with that, people are eating more fat, meat and other carbohydrate-based products than ever. These dietary changes and sedentary lifestyles have created a disease burden for the country, mainly in the urban people. 

After improving food production, India should focus on assuring nutrition security by promoting diet diversity and micronutrients consumption to tackle several deficiencies and nutrition-related challenges. The government has highlighted the need for more sustained efforts to accelerate food and nutrition security on several occasions. Some of the significant steps taken to ensure food and nutrition safety since the 1990s include National Nutrition Policy, Integrated Child Development Services (ICDS), Special Nutrition Program, Wheat Based Nutrition Program, Mid-day Meal program and most recently, the Prime Minister\’s Overarching Scheme to Holistic Nutrition (POSHAN) Abhiyaan. These are all multi-sectoral strategies and programs for eliminating malnutrition with direct and indirect interventions around food fortification, combating micronutrient deficiency, improvement in dietary patterns, food security, nutritional surveillance, community participation, etc. The policies also ensure greater access to adequate quantities of quality food at affordable prices, providing food and nutrition security to a large section of the targeted population.

That said, the Covid-19 pandemic hindered the physical availability of food, and the harvesting period of spring crops was affected. The government made temporary exemptions and in the agriculture sector, but there has been no consensus on the scale of disruption caused by the pandemic. Eradicating hunger and malnutrition is a complex problem. All interventions\’ progress will depend on an efficient governance system, cross-sectoral stakeholders\’ involvement, transparency and accountability, and finally, an equitable distribution of resources. An explicit political commitment is required for this. 

How Do We Move to Ensure Nutrition Security? 

From producers to consumers, all should also draw collective efforts to improve nutritional outcomes. We can start by converging the pathways of agriculture and nutrition. Ensuring critical components around bio-fortification of important crops/seeds, market-based solutions promote nutrition-dense products and incentivising the consumers through monetary or non-monetary initiatives are also steps to consider. It is even more critical to adopt transformative approaches. Empowering farmers and food entrepreneur committees, creating nutrition literacy to adopt sustainable, outcome-oriented farming practices should be included in essential interventions.

In addition to this, the existing and future agendas around agriculture and food security should be reviewed and assisted for implementation challenges. Policies should be designed to address communities\’ nutritional needs, apart from production growth and sufficiency orientation. The PDS can be further reformed to include various grains and pulses, iodised salt, and other fortified essential products for distribution among poor households. States like Chhattisgarh, Karnataka, Tamil Nadu have already started diversifying this, a practice which can be upscaled in other states. A variety of food items will ensure diet diversity, and women and children can consume essential nutrients at different vital phases of their lives. 

More importantly, the government and the non-government sector should facilitate this transition from being food secure to nutrition secure to create a demand for nutritious food at the community level. The government can make investments at scale, and the non-government sector can support implementation and reach to meet the service delivery gap. A multilayer convergence between stakeholders should enable community ownership, that malnutrition is their issue. This is possible with behaviour change communication strategies, nudges and positive reinforcements. 

India has a large young population, and its economy is growing, competing with even some developed nations. For a country with such growth viability, it is imperative to invest in an optimal food policy to ensure that its population can contribute their best in the nation-building process. 

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