The latest data regarding the status of nutrition in India’s nine poorest states reveals that most states have been successful in reducing the number of underweight children over the last decade. On the other hand, the scenario regarding child stunting has given mixed results. On one hand, Bihar and Uttarakhand have improved on all aspects, Uttar Pradesh has degraded on all of them.
The Office of the Registrar General of India released the results of the Clinical, Anthropometric and Biochemical (CAB) survey, which was conducted in 2014, this week. This survey was conducted as a part of the Annual Health Survey, which collects health information from a representative sample of every district in Bihar, Chattisgarh, Jharkhand, Madhya Pradesh, Odisha, Rajasthan, Uttar Pradesh, Uttarakhand–India’s eight Empowered Action Group (EAG) states– and Assam. In an exclusive survey, the CAB collected district-level data on key anthropometric indicators like child stunting, child wasting and children underweight.
This data was last collected in 2005-06 in the National Family Health Survey (NFHS) III. While NFHS III and CAB were conducted on different samples, the results are to be representative at the state level. An analogy between the NFHS and CAB reveals that eight of the nine states were successful to quite an extent in reducing the proportion of underweight children; Uttar Pradesh was the odd one out, where the proportion actually rose slightly over the last decade.
These revelations come in the backdrop of the NDA government’s turnabout over the release of the Rapid Survey of Children (RSOC), a nationwide sample survey instructed by the previous government and supervised by UNICEF. The RSOC revealed positive results in all child health indicators, but the results were initially kept secret by the new government and was later made public after media reported of leaked findings.
The RSOC’s findings on other child anthropometric indicators like child wasting and child stunting are comparatively more positive than the results gained from CAB. The RSOC showed improvements in all CAG states on child stunting, the CAB showed positive results in only five states– Assam, Bihar, Chattisgarh, Odisha and Uttarakhand. Only four states– Bihar, Jharkhand, Madhya Pradesh and Uttarakhand– showed positive results on the parameters of child wasting. Results of CAB confirm the findings of the RSOC, that girls were more likely to be underweight than boys in 2005-06 but 2014 results are vice-versa, where boys are slightly more likely to be underweight than girls.
New Delhi, November 2, 2017 : In his address to the nation on Independence Day, Prime Minister Narendra Modi talked about his resolve to build a Divya and Bhavya Bharat by creating opportunities for the youth and women and focusing on inclusive development, with safe housing and food security for the poor.
But has Modi ji forgotten about the depleting health status of the people in the south eastern part of the country, particularly the Adivasi populations?
Stemming from a region where people struggle to avail basic necessities how does Modi ji expect the youth to create jobs, when they are not even literate and healthy in the first place?
The health status of Adivasi women and communities in India is in need of special attention. One of the poorest and most marginalized communities in India, the tribal population continues to fight extreme levels of health deprivation, with women and children being most vulnerable.
Health Status of Adivasi Women
Due to rampant poverty, affording fruits and milk for sustenance is an issue affecting the health status of Adivasi women and communities. Additionally, most of the food is served to the male members, who are the bread-earners. As a result, the women have to survive on paani-bhaat (a dish made of stale or leftover rice and water) and saag made from drumstick leaves.
With little to no choice to avail other food items, they fail to meet adequate nutritional requirement for their bodies.
According to Archana Kisku, a General Nursing Midwife (GNM) at the Community Health Centre at Dumka district in Jharkhand, even water intake among Adivasi women is lower than what is required which makes them anemic.
“Most of the health centres at the block level in the state do not have blood banks and therefore these women have to be referred somewhere else,” Archana told ANI.
Multiple studies on the maternal health and health status of Adivasi women show poor nutritional status that continues to worsen, along with high rates or morbidity and mortality. Furthermore, tribal states of India record lower utilization of antenatal and postnatal services which can be attributed to illiteracy, monetary reasons, non-availability of services and even deep rooted cultural beliefs.
If you believe these conditions prevail only in Jharkhand, you are wrong. According to a study published in 2016, it was revealed that 80 per cent of the tribal women in Maharashtra’s Melghat area weighed less than 50 kg. ‘Starvation deaths’ continue to affect the health status of Adivasi women, with cases being reported even in advanced states like Kerala.
Thus, it must be realized that malnutrition and anemia are major problems affecting the health status of Adivasi women, irrespective of the area they reside in. However, it must also be noted that the problem is worse in states like Jharkhand and Chhatisgarh.
Health Problems Faced By Adivasi Population
While malnutrition and anemia continue to be the most reported cases, tribal populations are also faced with several endemic infectious diseases like tuberculosis, malaria and diarrhea, resulting in untimely deaths. According to a report published in The Hindu in 2016, the Sahariya tribe of Madhya Pradesh was reported to have the highest rates of tuberculosis in India.
Reasons for Poor Health Status of Adivasi Women
The main factors responsible for deteriorating health conditions of India’s Adivasi population can be attributed to
Questionable living conditions
lack of health education and literacy in general
absence or inaccessible healthcare facilities
The Adivasis are traditionally hunter-gatherers and depend upon the rich forests for their daily source of nutrients. Shifting to government schemes, like the Public Distribution System (PDS) takes them away from their natural state of being, replacing their diverse dietary food consumption in a forest to more restricted packages provided by the government.
Additionally, displacement from their traditional living conditions in forests puts them in a difficult situation, as the Adivasi’s struggle to survive on more ‘urban’ lands.
A major transition in livelihood affects the health status of Adivasi women and men, which then takes a toll.
Adivasi Women During Pregnancy and Childbirth
In an interview to ANI, Archana said, “Adivasi women don’t eat nutritious food during pregnancy and also don’t take iron pills on a regular basis because it is a myth amongst them that they will have problems at the time of delivery of the child due to the pill”.
Nearly 50 per cent of tribal women are known to have haemoglobin deficiency.
The pregnant women in Jharkhand’s Dumka district are found to have only 8 grams of, while 11-14 grams is found in a normal human body. This creates obstructions in childbirth.
Adivasi households are known to rear pigs and goats which diminishes their calcium requirement. Additionally, the womenfolk indulge in labor work and fetch water from far off distances which often result in miscarriages.
Adivasi Women and Anemia
As per figures from the National Family Health Survey 2015-2016, 71.5 per cent children between the ages of 6 to 59 months in rural areas of Jharkhand were found to be anemic. Furthermore, it was revealed that 67.3 per cent women within the age bracket 15-49 suffered from anemia.
Shockingly, this figure rose to a staggering 85 per cent in case of Adivasi women.
Nutrition, especially of the women, is of least importance in Adivasi communities, which when combined with poverty, lack of awareness and accessibility, create innumerable problems and negatively affect the health status of Adivasi women.
Anemic women naturally cannot be expected to have healthy children, which is why a negatively spiraling trend can be observed in India’s tribal population’s health.
Adivasi Women and Malnutrition
According to Dr Jugal Kishore, Director of Safdarjung Hospital, New Delhi, malnutrition is a major cause of deaths in India. He observes that one in every three women in India suffer from anemia. The case is worse in Jharkhand where three out of four women are anemic.
As the Adivasi women continue to be anemic, their children are also malnourished.
In a conversation with ANI, State Adviser of the Supreme Court in Jharkhand, Balram revealed the piteous state of pregnant women and nursing mothers who are unable to get adequate nutrition.
He pointed out that these women are unable to receive due benefits of government schemes due to their improper implementation. “Food Safety regulations are being overlooked. In Anganwadi centres there is no proper record maintained of how the health of children suffering from malnutrition is monitored,” he said.
Culture Has A Role To Play Too
Adivasi women continue to depend on midwives to do their deliveries, instead of going to health centres or hospitals. It is also a common belief that consumption of iron or pills would hamper the health status of Adivasi women and their children.
Due to the customs and traditions being passed on over generations, some Adivasi women do not breastfeed their new born after birth, which gravely affects the health of the mother and child alike.
Many such cultural practices also support the proliferation of malnutrition among the Adivasi populations.
State of Public Healthcare Facilities
Despite establishment of Primary Healthcare Centres (PHC) in tribal areas, quality healthcare is still a dream for India’s tribal population.
These PHC are often at a dearth of doctors and trained paremedics. The non-availability of essential drugs, and proper infrastructure further worsen the case.
Lack of knowledge and transportation in Adivasi regions is a huge drawback and travelling on foot to the PHC is a restraint for the tribal population which further hinders quality healthcare delivery.
Illiteracy is also a major factor for absence of good healthcare, as Adivasis’ fail to realize the need for healthcare and rights for care-seeking.
Even though the Adivasi community of India is deep rooted in traditions and superstitions, they have relatively accepted modern medicine in the last few years. But access to good health care continues to be a major issue of concern.
What Is The State Doing Regarding The Health Status Of Adivasi Women?
Jharkhand Welfare Minister Dr Lewis Marandi asserted that the state government is constantly making efforts to eradicate malnutrition and anemia, as per ANI report.
For the same, malnutrition centres have been opened in various districts of Jharkhand and the government is additionally providing supplementary nutritious food to children between the age of 6 to 72 months at meager costs.
Dr Kishore believes these supplementary food packages are also being sent for pregnant women, but they are not reaching the intended targets in rural and Adivasi areas.
The Road Ahead
As noted by the United Nations Children Fund, India has the highest tally of malnourished children in India. In this regard, in their efforts of remove malnutrition, the central government plans to introduce schemes guaranteeing increased amount of nutritional supplements to pregnant women and lactating mothers.
The State government has also been instructed to improve and closely monitor the functioning of PHC. Recently, the state government in Chhatisgarh extended livelihood opportunities to Adivasi women by training them to drive e-rickshaws, which are also expected to serve as ambulances in case of emergencies.
Similar initiative must be taken in Jharkhand and other states with Adivasi populations to bring the tribal communities to the mainstream.
However, what is crucial at the moment is for the government to spread awareness about the health of women, which must be given equal attention as the health of men in the Adivasi communities. At the same time, it is important to break the superstitions operational around the health status of Adivasi women.
Latest reports of WHO, UNICEF, and the U.S. Centers for Disease Control and Prevention say the rate of deaths from measles has dropped.
As per experts, a number of people who died from measles in 2016 were about 90,000, compared to 550,000 in 2000.
The World Health Organization, UNICEF, and the U.S. Centers for Disease Control and Prevention say the rate of deaths from measles has dropped 84 percent since the beginning of a global vaccination campaign in 2000.
Experts say the number of people who died from the disease in 2016 was about 90,000, compared to more than 550,000 deaths in 2000. This marks the first time that worldwide measles deaths have fallen to less than 100,000 per year.
Robert Linkins, of the Measles and Rubella Initiative at the CDC, said in a statement that “saving an average of 1.3 million lives per year through vaccine is an incredible achievement and makes a world free of measles seem possible, even probable, in our lifetime.”
Since 2000, some 5.5 billion doses of measles vaccine have been administered to children through routine immunization services and mass vaccination campaigns. The disease is contagious through air particles and can spread quickly. The disease kills more people every year than any other vaccine-preventable disease.
But the WHO says the world is still far from reaching regional measles elimination goals. Since 2009, officials have managed to deliver a first dose of the vaccine to 85 percent of the babies who need it, but there has been no improvement in that rate in eight years. And only 64 percent of the affected population has gotten the second dose, which comes when a child is four or five years old.
The WHO says “far too many children” — about 20.8 million — have not had their first vaccine dose. Most of those children live in Nigeria, India, Pakistan, Indonesia, Ethiopia and the Democratic Republic of Congo.
The disease puts children at risk of developing complications such as pneumonia, diarrhea, encephalitis, and blindness.(VOA)
Mumbai, Oct 25 : Megastar Amitabh Bachchan, who has served as Unicef Goodwill Ambassador for the polio eradication campaign in India, says he is fortunate to be the top most influencer for the organisation.
Amitabh on Tuesday shared a list of names of top influencers.
“Among top ‘influencers’ for fight against polio, a list by Unicef. Privileged to be the top most influencer. Thank you UN!” Big B tweeted.
The actor, 75, has been supporting and promoting various health and related issues such as childhood immunization programme, anti-tuberculosis campaign and the ‘Clean India’ initiative.
“Unicef Polio; World Polio Day, every child deserves to live a polio free life! I worked eight years on it and today India is polio free.”
On the acting front, Amitabh, who has wrapped up shooting for “Kaun Banega Crorepati”, has two films in his kitty — “Thugs Of Hindostan” and “102 Not Out” (IANS)