Urban Malnutrition

"The state shall regard the raising of the levels of nutrition and the standard of living of the people and the improvement of pubic health as among its primary duties" The Indian Constitution, Art 47

Urban malnutrition is not so much a result of the lack of awareness of a balanced diet but directly arising out of lack of livelihood opportunities. The difference in the rate of Malnutrition between the slum and non slum children is indicative of the fact that the food entitlements are not reaching the poor (as evident in the table below).

NFHS Estimates of the incidence of Under Nutrition among children under three years of age (percentage) in Mumbai -

	Weight for Age	Height for Age	Weight for Height
Slum	42.9	30.8	14.8
Non Slum	24	16.8	11.7
Mumbai	38.0	27.1	13.9

Evidence to the starkest contrasts of urban living is the difference in the quality of life of the tribal families and the non tribal families, the poor and the rich. In Maharashtra, 60.4% of children below the age of three who belong to the 'low standard of living index' are falling short of the needed weight for age, in contrast to about 27.5% of those belonging to the 'high standard of living category'. The contrast is starker when considering the fact that out of the former category 29.1% are severely under nourished against only 4.2% in the latter category. 73.6% tribal children (includes urban and rural) in Maharashtra suffer from malnutrition, as recorded by the last available National Nutrition Monitoring Bureau (NNMB) report of 1998-99.

CRY's experiential learning confirms that malnutrition of such magnitude cannot be tackled by only treating symptoms like anemia or diseases that are a result of decreased immunity. There has to be recognition and comprehensive intervention of the primary issue, which is lack of livelihood that results in food insecurity for the community and its children. When one examines as to who are the malnourished, that fall in the food insecure category in urban India, we see that most of them are economically or socially disadvantaged migrants and like in Mumbai the tribal's in jungles trapped under the urban cover.

Children being the most vulnerable are the first to succumb to malnourishment. Linkages indicate untapped potential of rural resources, few opportunities, and lack of livelihood options for parents as prime reasons for these migrations. Also contributing to this is the break down of the Public Distribution System (PDS) and the weak Employment Guarantee Scheme (EGS) that are at policy level devised to address livelihood & survival issues of the poor. Lack of & ineffectual Employment Guarantee Scheme (EGS) has lead to vast migration to the cities from rural Maharashtra and also from other parts of the country. While migration in Maharashtra for example starts after Diwali, the EGS activity starts somewhere in March. In the mean time communities have no choice but to migrate! In Mumbai again the livelihood opportunities are fiercely competed for, leading to sub-optimal work terms & conditions, the quality of life is hence dismal. Most belong to the unorganized sector where there is no guarantee of the minimum wage; working conditions are not just poor but many a time bordering on the hazardous.

Another of the safety nets in place was the Public Distribution System which was converted into the Targeted Public Distribution System (TPDS) in 1997. The scheme led to exclusion or restrictive access for some BPL families in turn perpetuating the food insecurity. Food entitlements have been cut by half, while India had it largest surplus ever lying unused. Whether in Dharavi or in Tribal hamlets of Thane district, the quality, access and availability of food through the system is dismal. Food that is provided through the system is substandard, never available on time and long queues are a norm. Another factor is that tribal families mainly depend on the forest for their livelihood, whether in Melghat or Borivali, Mumbai. The restricted access to the forest has left communities without options for livelihood. In Mumbai for example the 1500 family strong tribal population in the National Park area are considered "encroachers" of the forest that they have lived in for generations. The main livelihood needs of the people are met through hawking of minor forest produce. This occupation of theirs is met with constant threats from state and other interest groups. These sections of population (most of them landless) increasingly dependent on EGS & PDS systems that we witness today are malfunctioning.

On a macro scale, with 'liberalisation' food grain prices have swayed to market economics. Even the prices of food grains under the PDS have been periodically hiked. Illustrating this is the fact that between 1990-91 cereal prices rose 30% more than prices of other commodities in India. As a result people decrease their annual consumption of cereals between 1991 and 1998 by 16.3 kg per capita or 81.5 kg (per annum) for a household of five. Therefore it is true that the malnutrition levels have increased, not because they are the poor are unaware that they have to have a balanced diet which includes cereals, but because they cannot afford it. Cereal consumption in 1998 was as low as 144.9 kg per capita - against a minimum of 157 kg. Simply put there is no money to buy enough food!!! 90% of the urban households spend more than half their income on food; this is a clear sign of food insecurity. The denial of Livelihood opportunities is the root cause of malnutrition.

About CRY: CRY is a leading Indian non profit organization working for child rights. CRY believes that each child has a right to survival, protection, development and participation in an environment of equal opportunity. CRY's approach to sustainable development is based on the firm belief of community empowerment and citizen action whilst holding the state responsible for ensuring children's rights. CRY's objective is to demonstrate that real, sustainable change is possible through the building of grassroots models and through concerted advocacy for child rights.

For more information please contact:
Madhura Kapdi CRY (Child Relief & You)
Tel:(022) 23096845/6472
Email:cryinfo.mum@crymail.org