Undernutrition in India: What is behind the high rates for women

A child’s upper arm is measured at an Anganwadi center in the village of Baggad, in Madhya Pradesh’s Dhar district. (Credit: Russell Watkins/Department for International Development)

Undernutrition is a major problem in India and understanding its roots is also a challenge. A complex mash-up of gender discrimination and poverty among child-bearing women appears to be the starting point, according to recent research.

Roughly 42 percent of women in India start their pregnancies underweight, according to a recent study. That is far worse than sub-Saharan Africa where the underweight rate is estimated at 16 percent. The data may help explain why the rate of underweight children is worse in South Asia than in sub-Saharan Africa – a disparity known as the “Asian enigma.”

The study cites discrimination against women as one reason, which the New York Times included in its reporting on the study.

The reasons for Indian mothers’ relatively poor health are many, including a culture that discriminates against them. Sex differences in education, employment outside the home, and infant mortality are all greater in India than in Africa.

The general thought is that reducing poverty is correlated with an improvement in nutrition. That trend appears to hold everywhere but in South Asia. While discrimination may make things worse for women, it doesn’t explain the entire problem.

“Although certainly important, discrimination against young women is not the only reason why maternal health is so poor,” writes study author Diane Coffey of Princeton University, in the conclusions for her study published in the Proceedings of the National Academy of Sciences in the United States of America. “Indeed, India’s most recent DHS shows that the prevalence of underweight is 25 percent among men aged 40-50; these are the household members with the highest intrahousehold status.”

A high number of both women and men in India do not consume enough food and nutrients. Marc Bellemare, an economist specializing in agriculture at the University of Minnesota, agrees that discrimination isn’t the only factor driving the undernutrition rates among women.

“Look, discrimination against women is a problem in India. But it is also a problem in Africa, where the DHS routinely include questions about domestic violence, given how widespread it is, and where studies of intrahousehold allocations also show that women get the short end of the stick when it comes to food and nutrients,” writes Bellemare in a recent blog post.

What stands out is anemia in South Asia. UNICEF estimates that 60 percent of women in the region are anemic, higher than the 40 percent rate for sub-Saharan Africa. In India, the rate of anemia spikes to 83 percent during pregnancy. And more than 80 percent of young girls of anemic.

The discrepancy indicates that the New York Times may be on to a significant driver of the Asian enigma. Bellemare suggests that it also has to do with diet, citing the fact that Indians eat less meat on average than just about anyone else in the world.

Some answers may come from neighboring Bangladesh. The country has managed to reduce undernutrition over 20 years as its economy grew. The International Food Policy Research Institute credits improved access to education and economic growth as the leading contributors to the change. Other factors that helped the country include improved access to sanitation, better family planning services and access, programs targeted at improving childhood nutrition and agricultural development.

These points don’t really provide a comprehensive plan to solving the problem. Plus it is missing a gender analysis that may give better insights as to how discrimination may play a role.

The exact solution will need to address diet, gender discrimination, inequality and more.

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Tom Murphy

Tom Murphy is a New Hampshire-based reporter for Humanosphere. Before joining Humanosphere, Tom founded and edited the aid blog A View From the Cave. His work has appeared in Foreign Policy, the Huffington Post, the Guardian, GlobalPost and Christian Science Monitor. He tweets at @viewfromthecave. Contact him at tmurphy[at]humanosphere.org.