The Shameful Picture of Family Health in India

Partha Sarathi

The recently published Fifth National Family Health Survey 2019-20 done at the behest of the Central Government exposes the nature of (under) development persisting in the country so far as people’s health is concerned. And in West Bengal, people are tired of hearing the competing voices of the state’s ruling party TMC and that of the main opposition party BJP counterposing the so-called ‘development’ of Bengal and Gujarat, each claiming to have made big progress for the respective states. In this context, it would be pertinent to make a comparative study of the status of child and women’s health, the basis of family health, of these two states in the context of all-India averages, drawn from the NFHS data.

Although girl children usually face discrimination in the gender-biased society which was not much reflected in the NFHS, as the rate of malnutrition is found to be high among them, but not significantly. So, one may consider the health conditionsof children as a whole for this study.

Now, the (mal)nutritional status among children under the age of 5 years is measured on four health standards: 1) Stunted, based on a child’s height and age, is a measure of chronic nutritional deficiency, 2) Wasted, based on a child’s weight and height, is a measure of acute nutritional deficiency,3) Underweight, based on weight and age, is a composite measure of both acute and chronic statuses and 4) Anaemic (<11.0 g/dl).

A glance at the Indian average shows not only alarming but regressive picture of children’s health in India. According to the fifth NFHS, 36 percent of Indian children were found stunted, 27 percent wasted, 32 percent underweight and 67 percent anaemic. Alarmingly, anaemia among children has increased by 8 percent since the fourth NFHS was conducted in 2015-16. This is not only regressive, but shameful when compared to the world scenario of child malnutrition, where, Africa has the highest percentage (60 percent) of anaemic children. The Indian scenario is worse than that, showing the vulnerable situation in which the Indian children are growing up.

Now, if one comes down to the Indian states, with a few exceptions like Kerala, the child nutritional picture is quite distressing in most of the states. Here is a comparison between West Bengal and Gujarat. In Bengal, 34 percent of the children were found stunted, 27 percent wasted, 32 percent underweight and, 69 percent anaemic. Anaemic children had increased by 15 percent over the last 4 years, reflecting a more regressive picture than the national scenario.

Now, the status of child and woman malnutrition in Gujarat seems worse than Bengal. Among the children in Gujarat under 5 years, 39 percent were found stunted, 36 percent wasted, 40 percent underweight and 80 percent anaemic. Horrific figures of child malnourishment in a state that might otherwise boast of being the bulwark of Hindutva and thereby sending the chieftains to rule the biggest democracy of the world. Noteworthy, anaemic children here have increased by 17 percent since the fourth NFHS. These data collected under the Health and Family Welfare Ministry of Government of India shows the kind of ‘progress’ actually happening in the lives of Indian people. And unfortunate for the rulers, they have hardly an opportunity to find the hands of ‘anti-nationals’ or ‘urban Naxals’ behind such ugly projection of the ground reality persisting in India.

Then the status of malnutrition among the Indian women, who are projected as‘Matri-shakti’ or women power by the saffron rulers and for upliftment of whom the central and state governments have launched several high-sounding development projects is equally miserable. But despite all their rhetoric, it is important to note that malnourishment is increasing among the Indian women in their child-bearing age of 15-49. It is found from the fifth NFHS data that 57 percent of non-pregnant women and 52 percent of pregnant women are suffering from anaemia and these figures have increased by 4 and 2 percentage since the last survey.

The health conditions of women in West Bengal and Gujarat are far worse than the national average. In West Bengal, 72 percent non-pregnant and 62 percent of pregnant women are anaemic, while in Gujarat the figures are 65 and 63 respectively. The matter of concern is that in both the states the percentages of anaemic women have increased by around 10 percent in the short span of 4 years since the fourth NFHS. Notably, these figures are ahead of average African countries where 57 percent of pregnant women are anaemic, while the world average is 42 percent.

If one searches the chronology behind child and maternal malnutrition, one finds absence of schooling and highdropout of girls and prevalence of child marriages among them persisting in the 21st century India. According to the NFHS, 46 percent of children born to mothers with no schooling are stunted, while 26 percent born to mothers having 12 class and more education are stunted. In case of wasted children the figures are 42 and 23 percent respectively.

The survey shows that till 2019-20, 28 percent of Indian women have never attended a school, while for West Bengal and Gujarat the corresponding figures are 23 and 27. Then, how many of the girls getting admitted in the primary schools reach the higher primary (i.e. V-VIII class) level? According to the Unified District Information System for Education (UDISE), again a central government initiative, nearly 6o million girls were admitted in primary schools all over India in the year 2013-14 and after six years in 2019-20 when they are supposed to be in the higher primary level, it was found that only 3.5 million among them had been admitted to the higher level. Such colossus is the extent of girls’ school dropout in India.

Corollary to this is the prevalence of early or child marriages, in which West Bengal is the most ‘advanced’ among all Indian states--- a mockery of the slogan ‘Egiye Bangla’. According to the fifth NFHS, 23 percent of the Indian girls are married off before the age of 18, while the percentage figures are 42 for West Bengal and 22 for Gujarat. Even after implementing several projects like Kanyashree, Rupashree etc to deter early marriage and promote schooling among girls in Bengal, why the situation is so gloomy calls for deeper study particularly in rural Bengal where 48 percent girls are married off before 18.

Because of such prevalence of early marriages among girls, 43 percent of the Indian girls became mothers at the premature age of 15-19 years, revealed the NFHS, when studies by World Health Organisation show that pregnancy before 20 years of age is the principal reason for malnutrition among both child and mother and responsible for increase in their mortality rate. In West Bengal an astounding 81 percent girls got pregnant before reaching 20, while the figure is 34 for Gujarat. According to NFHS, under 5 mortality rate (per thousand) in India is 42, while its world average is 37. The same is 25 in West Bengal, 38 in Gujarat and 60 in Uttar Pradesh.

 Kerala is the only major state in India which has 98 percent literacy among women and far less malnutrition among its children and women. In Kerala, only 4.5 percent girls are married before the age of 18, while 18 percent got pregnant before 20. Here, 23 percent children were found stunted, 21 percent wasted, 20 percent underweight and 40 percent anaemic. One might be tempted to conclude that Kerala has high women literacy and less malnutrition among its child and woman population because the state has been under Communist rule for a long period, but it will provoke the question why the situation has been so deplorable in West Bengal that remained under Communist rule for a record 34 years.

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Frontier
Vol 55, No. 4, Jul 24 - 30, 2022