Nutritional Security in India - Insights from the NSSO’s Household Consumption Expenditure Survey 2022-23

The Household Consumption Expenditure Survey (HCES) 2022-23, recently released by the National Statistical Office (NSO), offers critical insights into nutritional security in India. This survey provides comprehensive data on household consumption patterns for food and non-food items, calculating the per capita daily calorie intake essential for assessing nutritional well-being across the population.

Key Findings of the HCES Report on Nutrition Security

1. Nutritional Insecurity Among the Poorest Population:

The average daily per capita calorie intake (PCCI) for a healthy life is 2,172 kcal in rural India and 2,135 kcal in urban India. The poorest 10% of the population consumes significantly less than these averages, with a PCCI ranging from 1,564-1,764 kcal in rural areas and 1,607-1,773 kcal in urban areas.

2. Variation in Nutritional Insecurity:

Within the poorest 10%, the average PCCI for the lowest 5% in rural areas is 1,564 kcal, while the next poorest 5% consumes 1,764 kcal. Urban counterparts show similar patterns with PCCI figures of 1,607 kcal and 1,773 kcal, respectively.

3. Proportion of Deprived Individuals:

The report estimates that 17.1% of the rural population and 14% of the urban population fall below the nutritional threshold based on PCCI. These findings emphasize the urgent need for policies aimed at enhancing nutritional security alongside existing food security measures in India

Understanding Nutritional Security

Nutritional Security is defined by the FAO (2009) as the physical, economic, and social access to a balanced diet, clean drinking water, a safe environment, and health care (both preventive and curative) for every individual.

Current Status of Nutritional Insecurity in India

Despite a significant decline in extreme poverty—falling from 45.9% to 13.4% between 1993 and 2015—India continues to grapple with a high burden of malnutrition:

a. Anaemia affects more than half of women aged 15-49.

b. Stunting (low height-for-age) in children under five stands at 35.5%.

c. Wasting (low weight-for-height) affects 19.3% of children under five.

d. Underweight children constitute 32.1% of the population.

e. Double Burden of Nutritional Insecurity

A recent study published in The Lancet indicates a troubling trend: India faces a double burden of nutritional insecurity, with rising rates of both malnutrition and obesity, impacting health outcomes across demographics.

Factors Contributing to Nutritional Insecurity

Several interrelated factors contribute to the persistent nutritional insecurity in India:

1. Affordability Issues: Poor households struggle to afford nutritious foods, exacerbated by growing wealth inequality, where the top 10% control 57% of national income.

2. Focus on Staple Crops: Agricultural policies have historically prioritized staple crops like wheat and rice, neglecting diverse, nutrient-rich options, leading to micronutrient deficiencies.

3. Calorie Fundamentalism: Existing food distribution schemes emphasize calorie intake, often at the expense of nutritional diversity and quality.

4. Marginalization of Women in Nutrition: Nutritional needs of women, particularly adolescents and young females in low-income households, are frequently overlooked, resulting in malnutrition and related health issues.

5. Childcare Practices: Inadequate implementation of recommended childcare practices, such as exclusive breastfeeding and the introduction of diverse diets, hampers child nutrition.

6. Rise of Fast Food Culture: The increasing availability and affordability of processed and fast foods have led to a decline in traditional, nutritious diets.

7. Urbanization and Income Growth: Higher income levels often correlate with increased consumption of unhealthy, processed foods and a decline in physical activity.

Consequences of Malnutrition

Malnutrition has far-reaching implications, including:

Child Mortality: An estimated 68% of child deaths under five years can be attributed to malnutrition.

Impaired Child Development: Obesity and malnutrition hinder physical and cognitive growth in children.

Psychosocial Challenges: Malnourished individuals often face stigma, impacting their mental health and self-esteem.

Economic Burden: Malnutrition incurs significant economic costs due to decreased productivity and increased health care expenses.

Social Inequality: Malnutrition perpetuates socio-economic disparities, disproportionately affecting vulnerable populations, particularly women.

Government Initiatives for Nutritional Security

In response to these challenges, several initiatives have been launched:

1. National Nutrition Mission (NNM): Aims to reduce stunting, underweight, and anemia among vulnerable groups by 2022.

2. National Nutrition Strategy (2017): Targets a reduction in underweight children by three percentage points annually.

3. Breastfeeding Promotion Programs: Initiatives like MAA (Mother’s Absolute Affection) focus on promoting breastfeeding practices.

4. Integrated Child Development Services (ICDS): Provides comprehensive services including nutrition, education, and health care for children and mothers.

5. Midday Meal Scheme: Offers cooked meals to children in schools to improve their nutritional intake.

Way Forward

To effectively address nutritional insecurity, the following strategies are essential:

a. Policy Shift: Agricultural policies must prioritize nutrition-sensitive approaches, emphasizing a diverse food basket to enhance overall nutritional status.

b. Innovative Solutions: Techniques such as bio-fortification can improve micronutrient intake, particularly among vulnerable groups.

c. WASH Initiatives: Integrating water, sanitation, and hygiene (WASH) programs with nutrition interventions will amplify health outcomes.

d. Focus on Women’s Education: Enhancing educational opportunities for women can lead to better nutrition practices and improved child health.

e. Healthcare Improvements: Strengthening access to maternal and child healthcare services is critical for tackling undernutrition.

f. Learning from Global Practices: India can draw lessons from successful international interventions, such as Brazil’s focus on agricultural R&D and social protection programs, and China’s commitment to early childhood development.

Conclusion

Addressing nutritional insecurity in India requires a multifaceted approach that includes policy reforms, innovative strategies, and enhanced focus on vulnerable populations. By prioritizing nutritional security alongside food security, India can work towards a healthier, more equitable future for all its citizens.