Understanding malnutrition in India

Malnutrition is one of the largest factors supressing India's spectacular growth. In a country of lunar missions, billionaires, and nuclear power, a staggering 46% of all India children under 5 years old are still underweight. In India, where everything is on a large scale, malnutrition is daunting - an estimated 200 million children are underweight at any given time, with more than 6 million of those children suffering from the worst form of malnutrition, severe acute malnutrition. Experts estimate that malnutrition constitutes over 22% of India's disease burden, making malnutrition one of the nation's largest health threats.

The causes of malnutrition and therefore the solutions to the problem vary as much as the Indian people. To understand and solve malnutrition requires patience, nuance, flexibility, and above all determination.

Follow me as I set out to understand malnutrition in the subcontinent and begin to tackle it

Tuesday, March 2, 2010

Barwani - NGOs galour

Barwani has the luck, or the curse, of having one of the highest rates of NGOs per capita in the state. There are hundreds of NGOs, with hundreds of missions and a fleet of professional NGO staff milling about the district. With this much activity on would think that basic development indicators should be on the rise.


Not exactly.


Our first meeting, like in every other district, was with the District Collector, the senior most official in the district who looks after all programs. He was enthusiastic to hear that we’re going to be starting work on nutrition in his district since he considers malnutrition is a serious and underestimated problem. He told us about an internal district government survey in which they determined that malnutrition is at least 10 times what is being reported. This is the first time I’ve heard of a district conducting this type of internal nutrition analysis and while we couldn’t get our hands on this report, I’m ready to believe the Collector’s opinion and suggestions on where to work in Barwani – Parti block.

At the same time the Collector was friendly and encouraging towards us, he was also quite frank: “Go ahead and start your work in our district, and next time you visit this office make sure you can bring some results from your work on the ground.” This Collector must receive dozens of requests from NGOs a day – for funding, signatures, appearances, etc – but probably doesn’t see many deliver. I hope we can.


Out of the many NGOs in the area local contacts told us that many are radical entities associated political parties or social groups. Others are just NGOs on paper. We did however find a few NGOs doing great work in the area. Swasthay Vardihni is working in empowering communities, providing innovative microinsurance schemes, and advocating for the elderly. One of their dedicated staff members also runs a school for tribal children in Parti block, the most remote area of the district. KDSS’ local arm, ASHA Gram, is also active here, supporting some long standing livelihood programs and running large scale medical camps and facilities throughout the district. While there are other NGOs like these doing great work in the district, no one is working in malnutrition.


Our NGO friends helped guide us to choose underserved villages with high rates of malnutrition to begin our intervention. The eastern half of Barwani is doing fairly well according to most local accounts. There is a major highway running through this area that connects the district easily with Bhopal, Nagpur, and Mumbai. This connectivity means not only ease in getting goods to market, but also that business and industry has developed along this convenient route and all the economies that these small scale ventures can bring. We therefore, decided to focus our intervention in the most remote area of the district, Parti block, where access is extremely limited. An estimated 60% of the block is inaccessible by road and its villages quite spread out and remote. The other 40% are connected fairly well to the one road in the block.


Given the remoteness of Parti block we again decided to plan our intervention around the availability of local staff. With the help of our local NGO friends, we were able to recruit over 30 handpicked women for interviews. I was pleasantly surprised by the level of education amongst many of the tribal women from remote parts of Parti and was touched by their desire to continue working in their villages despite their higher level of education. In a block with many logistical obstacles, we were able to quickly assemble a team I’m excited to work with.

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