(Dev 360, my new column for The Asian Age and Deccan  Chronicle, Reproduced from the 16.2.10 edition)

DEV  360

Op-Ed/Patralekha  Chatterjee

It is that time of the  year when discussions about India’s  growth  story reach a  feverish  pitch.  In the run-up to the Budget 2010, when GDP  forecasts are being tracked as keenly as cricket scores,  Planning Commission Deputy Chairman Montek Singh Ahluwalia  warmed the cockles  of our hearts by  telling  the crowd at  Davos  that  India could emerge as the fastest growing economy in the world, overtaking China.

Will  the GDP grow at 7 percent, 8 percent or  more? Economists, bankers, corporates, academics and other assorted folks  engaged in the game of number crunching,  all have their own guesstimates. To that, we can hazard our own, while  we wait for the Budget which will inevitably tell us what we can’t afford, but would not keep us from buying it.

But  there is another ‘growth story’ crying out for attention of our policymakers. In booming India, millions of children are not growing well.  India has a  higher percentage  of  undernourished children than Brazil,  China, and even Namibia and Kenya.  Given the numbers of affected, we cannot afford to sweep this problem under the carpet.

Last fortnight, I went  to an International Consultation on Human Development in India where  several experts argued that the challenge of child growth had to be accorded top priority not only for the sake of  equity but also economic growth.

Malnutrition affects a child’s  growth, brain development and  school performance. Stunted children learn less than normal children and learn it slower.  Malnutrition, thus,  affects  work performance leading  to productivity losses.. The World Bank estimates that preventing micronutrient deficiencies would increase GDP by at least $2.5 billion per year in India and China.

Consider  some  figures from UNICEF’s  flagship publication, The State of the World’s Children 2009:  28 percent of infants in India have low birth weight (2000-2007). The corresponding figure for Brazil is 8 percent and for China, 2 percent. 47.9 percent of children below the age of  three in India are stunted.The corresponding figures for Brazil are 7.1 percent, and for China, 21.8 percent.. 43.5 percent children under 5 in India are underweight. The corresponding figure for Brazil is 2.2 percent, and for China, 6.8 percent .

In terms of  growth, our children  trail behind not only those in  other  emerging economies but also many countries whose economies are doing far worse than ours. In 1950, for example, the real per capita income in India was two thirds of Kenya’s while today it stands at two and half times the Kenyan level.  But 16.5 percent of Kenya’s children under 5 are underweight against 43.5 percent in India!

These chilling  numbers are culled from a  presentation made by Mr T Sundararaman , executive  director  of the National Health System Resource Centre, at  the Consultation organized by the Institute  for  Human Development, a Delhi-based  think tank. The most disturbing feature is the slow rate of decline of malnutrition  in the years between the second National Family Health Survey (1998-99)and the third National Family Health Survey (2005-06). These have been  the boom years of the Indian economy.

Why are we in such a sorry state? A few insights I picked up at the Consultation are worth sharing.   The Ministry  of Health and Family  Welfare’s  allocations  for health has  shot up from Rs 10040 crores in 2005-’06 to Rs 22641 crores in 2009-10: a rise of 125 percent. Yet, the overall public expenditure on health ( all ministries, centre and state) as a percentage of  GDP remains low at 1.39 ( as of 2007-’08). This is lower than  Cuba ( 5.5 percent), Namibia (4.7 percent) and Sri Lanka ( 2 percent) to give three random examples from the developing world.

How is the situation on  the ground?. Just one example would suffice to make the point. India’s  Integrated  Child  Development Services (ICDS) is  the country’s primary response to early child development. Most  states  have a computerized  ICDS  monitoring system, but the available information is not used for  taking corrective and remedial action or for analysis. For instance, each anganwadi centre reports on the number of malnourished children category-wise, but these  figures   are neither verified independently  nor being  used for assessing the effectiveness of  programmes, N C Saxena, former secretary to the Planning Commission,  pointed  out in a  discussion paper  that was circulated at the Consultation

Despite massive  increases in the Union Budget and physical expansion of the programme in the last 10 years ( there are now 1.5 ICDS centres  per revenue village), the findings from the latest National Family Health Survey (NFHS III) show that a mere  32.9 percent  of  children  who live in an area covered  by an ICDS   centre  had  used  any service  from the centre  in the 12 months preceding the survey.

Tackling malnutrition  is not rocket science.  But its prevention requires collaboration between several sectors —  health, agriculture, education and community development The challenge is to orchestrate programmes in all of these spheres and make each player accountable.  An inspiring example is  neighbouring Thailand, which has been highly successful in rapidly reducing the prevalence of malnutrition. One key to the very significant and rapid progress came with their  fifth development plan (1982-1986), which focused firmly on the people’s participation, instead of leaving the Government to shoulder the entire burden. The primary health care approach was seen as a practical community-based and participatory mechanism to address persistent health problems, including malnutrition. This led to the training of village health communicators and health volunteers or mobilizers who, at the ratio of one mobilizer per ten households, can be found in virtually every village with a countrywide force of over 500,000.

Within the country, there are innovative experiences one can learn from  such as the Velugu Project  of  Andhra Pradesh.

The activists’ cry for equity and social justice go unheard.  May be it is time to be the materialist, and position nutrition  as an investment, rather than simply as a form of social spending that governments grant poor people to the degree that governments prioritize equity.

Patralekha  Chatterjee writes on development issues in India and other emerging economies and can be reached at patralekha.chatterjee@gmail.com


3 thoughts on “GDP and child growth

  1. Hi Patra,

    You really bring out things one assumes are being looked after by the GOI.
    Thanks for this majorly revealing piece…great homework done by you.

    …As also for all your other posts, which I never miss reading in detail…so no-reply from here doesn’t mean we aren’t reading.

    Push on, you who walk-to-your-own-beat.



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