Abstract
Over the past decade, India’s economic growth has been remarkable – yet almost half of India’s children under 5 remain stunted. The National Food Security Bill is the country’s response to this critical situation. Studies reveal that Indian children are chronically undernourished, not only because of lack of food but also because of recurring gastrointestinal infections. The stunting problem revolves more around lack of sanitation than food insecurity. Despite acknowledging that malnutrition is ‘complex and multidimensional’, government action has consisted largely of nutritional interventions and subsidized food. Although improvements in sanitation would be the most effective way to reduce excessively high levels of chronic undernutrition and stunting, a review of policy formulation and implementation reveals deficits and disconnects with available scientific evidence. It is time to change these mistaken assumptions and focus on improving access and use of safe sanitation facilities to achieve India’s nutritional goals.
References and Notes
The HUNGaMA (Hunger and Malnutrition) Survey Report – 2011, hungamaforchange.org/HungamaBKDec11LR.pdf, accessed 14 July 2014.
The National Food Security Bill, 20l3 – The Hindu, http://www.thehindu.com/multimedia/archive/01404/Summary_of_the_Nat_1404267a.pdf, accessed 18 July 2014.
National Sample Survey India. (2009–2010) National Sample Survey Reports – Ministry of Statistics and.Program Implementation, mospi.nic.in/Mospi_New/site/inner.aspx?status=3&menu_id=31, accessed 20 July 2014.
Lord of Corruption Ring: Food Security Bill!!!!!! Posted: 25 May 2013 in Food Security Bill, accessed 1 August 2014.
Dean Spears Policy Research Working Papers. How much international variation in child height can … http://sanitationdrive2015.org/wp-content/uploads/2013/09/sanitation-height.pdf, accessed 8 August 2014.
National Sample Survey India. (2004–2005) National Sample Survey Reports – Ministry of Statistics and.Program Implementation, mospi.nic.in/Mospi_New/site/inner.aspx?status=3&menu_id=31, accessed 20 July 2014.
National Family Health Survey India. (2005–2006) National Family Health Survey Report (NFHS-3), http://www.rchiips.org/nfhs/nfhs3.shtml, accessed 8 August 2014.
Günther, Fink, Günther, I. and Hill, K. (2011) The effect of water and sanitation on child health: Evidence from the demographic and health surveys 1986–2007. International Journal of Epidemiology 40 (5): 1196–1204.
Checkley, W. et al (2004) Effect of water and sanitation on childhood health in a poor Peruvian peri-urban community. Lancet 363 (9403): 112–118.
Esrey, S.A. (1996) Water, waste, and well-being: A multicountry study. American Journal of Epidemiology 143 (6): 608–623.
Checkley, W. et al and The Childhood Malnutrition and Infection Network. (2008) Multi-country analysis of the effects of diarrhoea on childhood stunting. International Journal of Epidemiology 37 (4): 816–830.
Lunn, P.G., Northrop-Clewes, C.A. and Downes, R.M. (1991) Intestinalpermeability, mucosal injury, and growth faltering in Gambianinfants. Lancet 338 (8772): 907–910.
WHO. The international drinking water supply and sanitationdecade: End of decade review (as at December 1990) (WHO/CWS/92·12). Geneva: World Health Organization, 1992 www.who.int › WHO IRIS › Headquarters › Technical Documents, accessed 14 August 2014.
National Sample Survey India. (2012) mospi.nic.in/Mospi_New/site/inner.aspx?status=3&menu_id=31, accessed 20 July 2014.
Sanitation Quality, Use, Access and Trends (SQUAT) Survey. (2014) Report, http://riceinstitute.org/wordpress/sanitation-quality-use-access-and-trends-squat-survey-2014/, accessed 20 August 2014.
Swachh Bharat Mission. (2014) inbministry.blogspot.com/p/canvas.htm, accessed 2 October 2014.
Sadanand Dhume – New Delhi’s Hunger Games – A misguided plan to provide subsidized grain to 800 million people is emblematic of India’s handout ethos – Wall Street Journal Opinion, accessed 1 August 2014.
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The author challenges India's singular focus on nutritional interventions and subsidized food for children. Studies show sanitation and clean water are the keys for India to improve the health and growth of children-in a country with fewer latrines toilets per capita than in many parts of Africa.
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Dobe, M. Viewpoint: The role of sanitation in malnutrition – A science and policy controversy in India. J Public Health Pol 36, 7–14 (2015). https://doi.org/10.1057/jphp.2014.45
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DOI: https://doi.org/10.1057/jphp.2014.45