Why Indian Women Suffer from Malnutrition

Some time back, a friend’s mother was hospitalized and while checking her vital parameters the hospital found her to be suffering from severe malnutrition. It seemed rather strange to us because the family belonged to an upper middle class family and there should be no reason for malnutrition.

The lady in question, who was 70 years old, harboured some old fashioned notions about eating where she put the needs of her family before her own and the doctor said that while she was not starved it looked like she had not been getting the nutrients that were necessary for leading a healthy life.

This seems to be a malaise that affects women of all ages in India, but this has serious consequences for those who are of child-bearing age. A study by UNICEF  showed that about 33 percent of women during their reproductive years were undernourished with a body mass index lower than 18.5 (kg/m² ). The World Health Organisation’s Global Nutrition Report of 2017 observed that in India more than half of the women of reproductive age suffered from anemia (one of the markers of malnutrition).

Anemia in India is responsible for more than 20 percent of the maternal deaths.

Undernourished women give birth to babies who are malnourished and underweight, leading to high rates of infant mortality. Even if the children survive, their immunity levels are compromised and if they are not given proper nutrition, they in turn will give birth to babies who are undernourished and thus the cycle is perpetuated.

The Reason for Malnutrition

The reasons for malnutrition are many and it starts right from birth.

Poverty is one of the reasons for malnutrition. In low income countries or communities where means of livelihood are difficult, incidence of malnutrition are higher. Many times, especially in countries like India, cultural factors play a large part in the incidence of malnutrition in Indian women. Girls are seen as a liability and when it comes to allocating scarce food resources, they are usually deprived with the male children getting all the food.

Malnutrition is also prevalent in high-income countries and communities. This stems again from cultural factors as well as low awareness. Women in the household are usually the last ones to eat and they often wait for the men folk to finish their meals. I find this practice even in households where education levels are higher. Women usually do not eat with the rest of the family.

A friend of mine who stays in a Mumbai suburb and holds a good job has to prepare meals after she reaches home. By the time the family eats and she has her meal it is after midnight. Most of the days she is sleep deprived and this has an impact on her nutrition levels because her body is not efficient at processing any of the nutrients ingested. While outwardly she looks normal and healthy, she is prone to infections and has very poor reserves of strength of combat illnesses.

Suman Sahai, a genetic scientist, once told me that poor sanitation in the villages and urban areas led to diarrhea and this prevented nutrients from having any effect on the body even if they ate them.

Low levels of education are also responsible for malnutrition, because people do not know what they have to eat and when. As I said earlier, women’s nutrition is often the last on the list of priorities of many households.

Another report last year, the State of Food Security and Nutrition in the World report, observed that in India more than half of the women in the reproductive age category were anemic, a direct result of the malnutrition to which they were subject.

  

The Remedy to Tackle Malnutrition

Considering that about 15% of the population suffers from hunger in the country, the resources allocated towards malnutrition are scarce. While WHO has recommended that about 5 percent of the Gross Domestic Product should go towards healthcare, the government budget is just over 1 percent of the GDP.

There has been a slow rate of improvement due to schemes such as Integrated Child Development Scheme and privatization of healthcare. But more needs to be done and in a more intensive way especially with regard to diet and nutritional needs of women. For instance while the National Food Security Act, 2013 has been enacted it is yet to be implemented.

While there are plenty of programs for alleviating malnutrition and dealing with different aspects of undernourishment, the main problem lies in their implementation. 

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