Karnataka: malnutrition deaths despite high growth

Karnataka, Indias IT success story and its most preferred destination for foreign investment,
boasts of the countrys highest per capita income. Its economic indicators are nothing short of
superlative and yet the South Indian State accounts for thousands of child deaths due to
malnutrition. A recent report shows that despite high SGDP growth and heightened economic
activity, Karnataka fares poorly in hunger index and child malnutrition.

A recent report by news channel (TV9) showing a severely malnourished 5-year-old boy
Anjeneya and his subsequent death has drawn the States attention to the miseries of child
malnutrition in Raichur district and Karnataka as a whole.

The incident finds mention in a damning report by Clifton D Rozario, Advisor to
Commissioners of the Supreme Court in the case PUCL vs UoI & Ors. (W.P. No. 196 of
2001), commonly known as Right to Food case. (Link)

The report states that since April 2009 to August 2011, 2689 malnourished children have died in
the district of Raichur alone, and 4531 children are suffering from severe malnutrition.
Government functionaries, including Chief Minister Sadananda Gowda have admitted this.
Attributing it squarely on the apathy of government, the Advisor said he has repeatedly drawn
the attention of the authorities and the State Government to the grave situation in Raichur
district.

As per the official statistics acquired through the Right to Information, the details of deaths of
malnourished children are as follows:


Observing that childhood malnutrition violates several core human rights commitments at the
international level as well as Constitutional commitments, the Advisor says that the response of
the Government of Karnataka has been inadequate and deeply unmindful of the nature of its own
constitutional obligations. Though on paper there are schemes for malnourished children, it
does not appear to be adequate or translate into action, the report says.

Citing some of the key problems that prevent child malnutrition from being eliminated, the
report lists poor quality of food at the top. There appears to be widespread consensus that it is
unpalatable by the children, parents and anganwadi teachers, and further that it is not nutritious,
the report says.

A major problem lies in the identification of children who are suffering from malnutrition, a task
assigned to the Anganwadi Teacher who has to forward a list of such children to the Supervisor
for further action. The Advisors report points out problems at every stage there are no proper
weighing machines or scales in every anganwadi nor is it done every month for every child;
reports are not prepared properly; the Supervisor does not take suitable action on them; the
provisions for providing proper care, medicines and nutrition to identified children are
implemented only a handful of cases.

The Advisor observes that the vast majority of children suffering from severe malnutrition
belonged to the SC community, particularly to the Madiga sub caste. It can also be seen from
the visits conducted that the children affected were disproportionately female, he adds.

As for health care, the Advisor says, The implementation of the NRHM (National Rural Health
Mission) has been half-hearted and there are several instances of corruption in the matter.
Nurses and doctors do not visit hospitals regularly and do not take much interest.

The Advisor recommends a host of steps to fill the gaps in the system. He backs a suggestion
that community based nutrition centres should be started in villages with severely malnourished
children, possibly in the anganwadis itself. For this, the government should consider setting up
Nutrition Rehabilitation Centres (NRC), linked to the Community Health Centres or District
Hospitals. It has also suggested no child should be denied admission to NRCs.

The report cites the NFHS-3 data that paints a rather dismal picture of Karnataka in regard to the
health and nutrition status of children.

The infant mortality rate in Karnataka is estimated at 43 deaths before the age of one year per
1,000 live births. The under-five mortality rate is 55 deaths per 1,000 live births.
Infant mortality in rural areas (47) is 28 percent higher than in urban areas (37).
The Government of India recommends that children under three years receive vitamin A
supplements every six months, starting at age 9 months. However, only 23 percent of last-born
children age 12-35 months were given a vitamin A supplement in the past six months, and only
53 percent of children age 6-35 months ate vitamin A-rich foods during the day or night.

Childrens nutritional status as indicated by physical development:
44% of children under age five are stunted, or too short for their age.
18% of children are wasted, or too thin for their height.
38% are underweight.
Children in rural areas are more likely to be undernourished; but even in urban areas, more
than one-third of children under age five years suffer from chronic under nutrition.
70% of children between the ages of 6 and 59 months are anaemic.
More than half of women in Karnataka (52%) have anaemia. 63% of pregnant women are
anaemic.
Anaemia is much more widespread among children age 6-35 months than it was seven years
ago at the time of NFHS-2.

Further readings:
Child Malnutrition in Karnatakaby Adv. Clifton D Rozario (2011),
http://www.altlawforum.org/legal-advocacy/malnutrition-in-
karnataka/Malnutrition%20Report.pdf/at_download/file
Child Malnutrition in Karnataka-A Report by LawrenceLiang, 24 October, 2011,
http://kafila.org/2011/10/24/child-malnutrition-in-karnata
ka-a-report/
Child malnutrition: Myths andsolutions- A.K. Shiva Kumar
http://www.littlemag.com/hunger/shiv.html
The Child Malnutrition Myth-Whydoes nobody question the absurdly high numbers cited for
India?- ArvindPanagariya, The Times of India, 1 October, 2011,
http://articles.timesofindia.indiatimes.com/2011-10-01/edi
t-page/30230007_1_underweight-children-maternal-mortality-
mortality-rate
Karnataka HDR 2005, http://www.im4change.org/state-report/karnataka/12
Malnourishment: children of SC, ST families worst-hit, The Hindu, 24 November, 2011,
http://www.thehindu.com/todays-paper/tp-nation


Over 65,000 malnourished children in Karnataka, says NGO
Admin August 28, 2013 at 3:01 pm
The various government schemes designed to eradicate malnutrition from state seem to have
failed to hit the bulls eye. The number of infant deaths in the state because of malnutrition
seems to have remained unchanged.
As per government statistics, there are over 65,000 malnourished children in Karnataka, says an
NGO, United Ways of Bangalore (UWBe), citing figures from National Family Health Survey.
Belgaum tops the list with 7,587, followed by Raichur (6,089), Bellary (5,258), Koppal (4,496),
Gulbarga (4,436) and Bidar (1,216). Those figures, however, contrast with the data provided by
Karnataka minister for women and child development Umashree in the assembly on July 22, that
the state has only 3,549 children suffering from malnutrition. (Also read: Why the Govts Iron
and Folic Acid Supplementation Programme wont produce desired results (Exclusive
interview with Dr A.K.Susheela)
Though more than 90% of kids under the age of six are in areas covered by anganwadis, only
36% of them actually received services of some kind from these centres, according to UWBe.
The government is doing its bit as far as spending money on various schemes is concerned.
However, merely spending money will not help, there needs to be proper planning. It needs to
ensure that food distributed to children under the age of six actually has the right amount of
nutrition required for a child of that age, says nutritionist and scientist Dr KC Raghu.
For instance, the state government recently agreed to supply milk to children covered by
anganwadis. It agreed to include the same in their mid-day meal scheme. However, it decided to
supply skimmed milk powder to kids under the age of six while those covered under mid-day
meal scheme were given whole milk powder. Ideally it should have been the other way round.
Kids under the age of six need energy through fats and proteins. By giving them skimmed milk
we are in no way addressing their health issue properly, says Raghu.
According to Suresh Nair, executive director, United Way of Bengaluru (UWBe), the India wing
of a US not-for-profit organisation, there is little knowledge on nutrition required by kids when
they under six years of age. There are very few schemes run by government which cover kids in
this age group. If we intend to eradicate infant mortality, we need to catch them young, says
Nair. This can be done by educating the anganwadi workers and giving them access to clean
water and a hygienic place to operate from.
Experts even trashed governments recent step to distribute iron tablets among schoolchildren.
You need nutrition through freshly cooked meals and not tablets, say doctors.
Statistics reveal that only 17-18% of children actually received health check-ups and growth
monitoring services at anganwadi centres. Experts say that most anganwadis do not have proper
buildings.
However, anganwadi workers say despite taking care of lakhs of women and children, the
government has turned a blind eye to their problems and woes. Many allege that despite repeated
requests, the government has not taken any step to increase their monthly salary.
There are 1.29 lakh anganwadi workers and assistants across the state. While the anganwadi
workers are paid Rs 4,500 per month, the anganwadi assistants are paid Rs 2,500.
----------------------------------------------------------------------------------------------------------------------------------