World Bank Report on Stunting

Why in news?

World Bank recently released a report on the prevalence and effects of stunting.

What are the highlights?

• A child is stunted if the height-for-age ratio is not proportionate.
• Effects - Children with stunted growth are more prone to enduring adverse outcomes later in life.
• They suffer from impaired brain development.
• This leads to lower cognitive and socio-emotional skills, and lower levels of educational attainment.
• India - The World Bank analysed 140 countries for workers who were stunted as children.
• Of these, only Afghanistan (67%) and Bangladesh (73%) surpassed India’s proportion (66%).
• Around 66% of the working population in India are earning 13% less.
• This is specifically because of lack of skills due to stunting in childhood.
• This is one of the highest proportions worldwide in such reductions in per capita income.
• Others - The average reduction for South Asia was 10% and North America 2%.
• Middle East and North Africa do better, with a reduction of 4%.
• This is better compared to Europe and Central Asia with a reduction of 5%.
• The economic impact of stunting was not limited to Asia and Africa.
• Stunting has affected almost all continents in varying amounts.
• But Indians lost more income than people, on average, from Sub-Saharan African countries.
• Notably, countries poorer than India have handled stunting better.
• E.g. Senegal, with a per capita GDP of half as that of India’s, was able to reduce stunting in its children by half over 19 years to 2012.
• Peru, too, demonstrated a remarkable decline in its childhood stunting characteristics.
• This was largely due to its nutrition, health and sanitation interventions.

• Returns - The World Bank report calculated that the returns on a national nutrition package outweigh the costs.
• This is in reference to interventions focussed mainly on maternal and neonatal health.
• But given the time lag between childhood and joining workforce, the effects begin to show only 15 years after implementation.
• After the initial 15 years, the cost remains static and the benefits continue to increase as more of the workforce begins to benefit.
• The average rate of return predicted for the programme was 17%.
• But for India the returns were forecast at 23%.

What is the current scenario?

• The percentage of childhood stunting in India’s current working-age population does not reflect the percentage of children currently stunted.
• This is given the gap between childhood and joining the workforce.
• Notably, the current number of stunted under-five children in India has reduced drastically.
• Over 26 years to 2014, the percentage of stunted Indian under-five children has reduced from around 62% to 38%.

What are the causes for India's state?

• Stunting is affected by a variety of socio-economic determinants.
• More than the economic development state, it reflects the treatment of women and children.
• The related causes for stunting lie in social inequity with women’s status and health, household wealth, access to services, etc.
• India clearly has inadequacies in women’s well-being and efforts to reduce poverty.
• The two most influential deciding factors are women’s BMI and women’s education.
• These factors explained the difference in child stunting between highly sensitive and less sensitive districts.

What lies ahead?

• In India, Integrated Child Development Services, PDS and mid-day meal schemes address children’s nutrition.
• The Swachh Bharat Abhiyan and the National Rural Water Drinking Programme address sanitation needs.
• Despite these, improving women’s well-being remains a challenge for policy.
• A nutrition-specific national programme could significantly tackle stunting.
• The National Nutrition Mission (POSHAN Abhiyan) should thus be promoted to address nutritional gaps for women.
• There has to be a specific focus in the lower income brackets if stunting is to be truly eradicated.

Source: Business Standard, Financial Express