Child malnutrition: ‘High rates due to flawed methodology’

The methodology used to calculate malnutrition is so flawed that it generates highly puffed-up figures on child malnutrition in India, including Kerala.

This is according to a paper presented by Indian economist Arvind Panagariya at the conference ‘India: Reforms, Economic Transformation and the Socially Disadvantaged’ held at the Columbia University, US.

While maintaining that malnutrition is a significant problem faced by India as a whole, Arvind Panagariya argues that the numerical incidence of child malnutrition is highly exaggerated on account of the faulty methodology employed to measure it.

Traditionally, what has been used to measure malnutrition were the height and weight of children, irrespective of race, culture, geography or environment.

“The methodology yields malnutrition estimates that contradict virtually all other indicators of child health such as infant mortality, mortality under-five and maternal mortality rates,’’ says Arvind Panagariya in his paper. He compared the state of Kerala, which has health indices approaching those in developed countries, with Senegal, one of the countries in sub-Saharan Africa whose per capita income close to that in India.

The author points out that the infant mortality rates in Senegal is four-and-a-quarter times that of Kerala, the under- five mortality rate is almost six times and the maternal mortality rate is over four times. Yet, it has lower stunting (low height for age) and underweight (low weight for age) rates, which means lower malnutrition rates.

“Better-nourished children in Senegal die at rates many times than those in Kerala and the same holds for their mothers,’’ says Arvind Panagariya. The percentage of children below 5 who are stunted in Kerala is 25 as against the 20 of Senegal. And the percentage of children below 5 who are underweight in Kerala is 23 as against the 15 of Senegal.

A comparison of the state of Punjab with Senegal exhibits a similar pattern, as does that of Mauritania in sub-Saharan Africa with Kerala. The author says that  these comparisons are not isolated examples.

‘A comparison of India with virtually every one of the 33 sub-Saharan countries with lower per capita incomes reproduces this comparison,’’ he says, demonstrating this by comparing India with the 33 countries in sub-Saharan Africa along health indicators such as life expectancy, infant mortality rate, under-five mortality rate, stillbirth rate and maternal mortality rate, which are way higher in most African countries.