Raise a stink over lack of toilets 

India home to world’s largest population of stunted children

Shocking stats
48mn Number of children under 5 with impaired development
774mn Indians without access to adequate sanitation
76mn So many Indians lack access to safe water
1.4L Under-fives die in India every year because of diarrhoea and other diseases
1% GDP Lost in India due to malnutrition of its children
55.3% Of women between the ages of 15 and 49 are anaemic in India
69.5% Indian children on average between the ages of six months to five years are found to be anaemic

India has the highest concentration in the world of people practising open defecation. Research shows that high rates of open defecation have a strong correlation with increased rates of stunning, as faeces in the environment contaminate hands and surroundings, and spread disease and infection

India’s lack of toilets and poor access to sanitation are holding back its children, causing stunted growth and curbing their development, according to a new report from Charity Water Aid. The country has more than 48 million under fives with impaired growth, a condition known as stunting. It is the largest number in the world. India has one of the world’s most-skewed sex ratios and one of the worst rates of child stunning. India also has 774 million people without access to adequate sanitation, and 76 million without safe water, the report said.

Children who are stunted because of malnutrition tend to be shorter and lag behind their peers cognitively. Poor access to clean water, sanitation and hygiene cause diarrhoea and expose children to other intestinal infections during the crucial first two years of life. Around 1,40,000 under-fives die in India every year because of diarrhoea and other diseases caused by lack of access to these basic services, the report said.

The report also emphasis that children who regularly have diarrhoea or other infections caused by poor wash are more likely to fall behind in school or even drop out altogether. Regular bouts of diarrhoea not only mean that children struggle to keep up at school because they are often absent, it can also cause stunting which affects the makeup of the brain and prevents children from reaching their potential. Reducing malnutrition increases cognitive development and contributes to learning and school completion rates.

Malnutrition not only has a huge human cost in terms of lives lost, it also inflicts a big economic burden. According to Global Nutrition Report 2016, the impact of malnutrition costs 11% of GDP annually across Africa and Asia and 1% of GDP in India. The impact and costs of low weight, poor child growth and deficiencies in vitamins and minerals add to the burden on health systems and affect development. Making sure communities are healthy can increase productivity and lead to more economic opportunities. Investing in water and sanitation can bring significant economic rewards.

India has won significant battles against childhood malnutrition in recent years, but it still needs to win the war. Nevertheless, the report says the country is still home to the world’s largest population of stunned children. As many as 48 million Indian children under the age of five are shorter than they should be and further 17 million suffer from an acute lack of nutrition. Indian inability to feed all its children properly threatens economic growth and represents the largest loss of human potential in any country in human history.

However, India has made progress on reducing child stunting from 48% of all children in 2006 to 39% in 2014, alongside the high numbers of people without access to adequate toilets. Over the same period childhood stunning declined to 36% from 43% in Bangladesh. Wealth does not necessarily equal health. Some of India’s richest States have higher incidence of malnourished children than those that are less well-off, and this is known as the Indian enigma. Child under nutrition rate in India is much higher than that in some countries of Sub-Saharan Africa, even though infant and child mortality rates in India are lower, according to the report.

The report also correlated female education with children’s growth and nourishment. The more educated a woman the more likely she will participate in economic decisions for a household and make those choices in favour of spending more on healthcare and food. Research shows maternal health is also intrinsically linked to the health of a child. Other indicators like body mass index, prevalence of anemia and height of a mother are now used to predict whether a child, whose mother is malnourished, will receive a proper diet. On an average, 55.3% of women between the ages of 15 and 49 are anaemic in India and 69.5% children on average between the ages of six months to five years are anemic, stated the report.

India has the highest concentration in the world of people practising open defecation. Research shows that high rates of open defecation have a strong correlation with increased rates of stunning, as faeces in the environment contaminate hands and surroundings, and spread disease and infection. Prime Minister Narendra Modi has said in the past that he would rather build toilets than temples setting a goal for every home in the country to have a place to go to the bathroom by 2019. But the programme has suffered challenges: some Indians prefer to relieve themselves outdoors.

By Gudipati Rajendera Kumar