While P.Chidambaram endorsed the controversial Food Security Ordinance at a press conference in Jaipur on July 16, there were doubts on how effectively the legislation will tackle all factors perpetuating malnutrition in India.
Congress leaders have officially touted the ordinance as their chief means to tackle malnutrition in the country. But data on the nutrition problem suggests that the legislation is inadequate to deal with certain facets of the issue. The ordinance currently stipulates five kg of foodgrain, classified as "coarse grain" (including rice, wheat, and millets) per person per month. However, Indian Council of Medical Research (ICMR) guidelines stipulate at least 16 kg for adults and seven kg for children.
The ordinance also fails to provide access to the entire basket of nutrients necessary to effectively improve the nutrition status of the target population. Calling it a "missed opportunity", Dr. Suneetha Kadiyala explained that the ordinance was "too focused on calories" and not on diet diversity. Kadiyala is a Research Fellow with the IFPRI (International Food Policy Research Institute) at New Delhi.
"The Food Security Bill does not give access to diversified food, which is what food security is all about", she said. "This is really the grain provision bill."
Kadiyala's critique points to rampant micronutrient deficiency and related diseases that perpetuate chronic undernutrition. While providing food grains will help increase access to calories, it will not ensure beneficiaries get all important nutrients.
Most cite iron deficiency and related anemia which claims 22,000 maternal deaths per year, according to ICMR. Latest ICMR data shows 87 per cent of pregnant women and 75 per cent of children below five years of age suffer from iron-deficiency anemia. UNICEF data shows that Vitamin A and iodine deficiencies are also significant public health problems relevant to the malnutrition challenge.
"[The ordinance] might prevent starvation related deaths; but is chronic under nutrition going to be addressed? I'm not sure," Kadiyala said.
However it might yet be salvageable, according to Kadiyala. The ordinance specifically provides for free meals to pregnant and nursing women (six months after childbirth) along with children up to 14 years, through local anganwadis (primary healthcare centres). These free meals can help pregnant women gain weight and maintain it as they nurse. It will consequently increase weights at birth, according to Kadiyala. More than a fourth of all newborns are 'low birth infants" weighing less than 2.5 kg, according to latest UNICEF data. A healthy infant weight is around 3 kg at birth, according to UNICEF.
Free meals to children, especially adolescent girls, can also increase their weight-for-age and allow them to have healthy pregnancies and infants, according to Kadiyala. But the success of free anganwadi meals is questionable especially after the deaths of 22 children in Bihar who consumed a mid-day meal made headlines this week.
While food security can be limited to access to more calories and diversified nutrients, any legislation will need to address sanitation shortcomings to truly attack all malnutrition problems. Diarrheal diseases, for example, create a perpetual cycle of deteriorating malnutrition; repeated episodes reduce the body's ability to absorb nutrients, according to Kadiyala. Diarrhea claims 13 per cent of all child mortalities, according to UNICEF.
"Several things need to work out for nutrition challenges," she said. "Another is [also] improved child feeding practices, such as [better] breastfeeding, to combat malnutrition effectively".
Studies continue to find links between nutritional status and sanitation. IFPRI has found in an ongoing exploratory analysis that access to clean toilets is most significant when explaining declining malnutrition in India's 'Hunger States'.