Millennium Post

Who’s to blame?

This defies logic. Despite rapid economic growth, India has often been placed below sub-Saharan African countries that have very high number of malnourished children. But the government has no data to clarify its position. In the first week of September, Parliament’s Committee on Estimates criticised the government, saying, ‘The committee is surprised to note that in the modern era of Information and Technology, there is no recent official data on malnutrition. What is available is the outdated National Family Health Survey-III data of 2005-2006.’ But efforts by experts to generate reliable malnutrition data in the country might go in vain due to raging debates over the way malnutrition is assessed.
The debate was sparked by an article by Arvind Panagariya, economist at Columbia University, US. In the article, published in a leading weekly in May this year, Panagariya compared several indicators of development and established that India has made significant progress in realising several development goals but lags in malnutrition. This mismatch could be due to a faulty formula of the World Health Organisation (WHO), which is used to measure malnutrition among children in the country, Panagariya wrote. The formula uses height and weight as yardsticks to measure growth. Panagariya argued that the height of an individual can vary depending on the nutrition status as well as genetic makeup. For instance, Indians are not genetically programmed to be as tall as WHO expects. But the WHO formula does not take this into account.

Panagariya is not the only one to have criticised WHO’s malnutrition measurement formula in the recent months. In July, economist Reuben Abraham, who is the executive director of the Centre for Emerging Markets Solutions at the Indian School of Business in Hyderabad, and a non-resident scholar at New York University, argued in a news daily that malnutrition is a multidimensional phenomenon. It should be categorised into protein deficiency and micronutrient deficiency, and diagnosed only through medical assessment.

Several health experts have also expressed doubt over the WHO formula. ‘How can one formula fit the entire world?’ asks Umesh Kapil, professor of human nutrition at the AIIMS, Delhi.

But India was among the six countries that were part of the WHO survey while preparing the formula. This means the formula should work well for India.Kapil explains why WHO’s formula fails in India. Using the formula, WHO measured the growth of a handful of children born and raised in the best settings and standardised the growth chart. But it is impossible for all children to have similar growth. India is a vast country with individuals belonging to many ethnic groups. In certain communities, people are of short stature. This does not mean they are malnourished, says Kapil, emphasising the need for separate formula for each community.

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