Despite rapid economic growth and the reduction of poverty in India over the past decades, food insecurity remains very high. This puzzle has been called the "South Asian enigma". Some indicators of food insecurity, especially child malnutrition rates, are now worse in India than in Ethiopia. This is despite the fact that Ethiopia has only a quarter of the per capita income of India and has suffered many famines in the 20th century.
A comparison of how the governments of these two countries handle food insecurity suggests that the key to solving the puzzle of South Asia lies in the feeding and sanitation of children in their first 1,000 days of life, from conception to second. birthday.
Support for pregnant women.
Malnutrition of Indian children often begins in the womb. Just over half of Indian women are iron deficient, compared to 23% of Ethiopian women. Iron deficiency in pregnancy can lead to a child's low weight and health problems.
One of the reasons for the difference is the lack of support for poor pregnant women in India. The National Food Safety Act of India, passed in 2013, ruled that all pregnant Indian women should receive a stipend of Rs. 6,000. But the money usually manages to cover only the shipping costs. It is also administered only in the first pregnancy of a woman, excluding more than half of the annual births in India.
Many poor women in India endure a heavy workload during their pregnancies, which compromises both their own food and that of their unborn children. In contrast, poor women in Ethiopia receive support from the Government-administered Productive Safety Net program from the fourth month of pregnancy to the first birthday of their child.
As a result of nutritional deficiencies in pregnancy, proportionately more children in India than in Ethiopia are born "very small". This difference in average weight increases with age. While 36% of Indian children under the age of five are underweight, only 24% of Ethiopian children are underweight.
The different trends in child weaning in these countries contribute to the growing gap. The World Health Organization (WHO) recommends supplementing babies with solid or semi-solid foods after six months of age, when breast milk alone no longer meets their nutritional needs. But almost a third of Indian children a year still consume only liquids.
The Ethiopian government made nutrition education for parents an important part of the latest version of its Productive Safety Net Program. Government-funded child care centers, called Anganwadi centers, have traditionally provided nutrition education in India, but their workers, mostly women, are poorly paid and, consequently, their service is deficient.
In addition to unbalanced diets, child malnutrition around the world has increasingly been linked to sanitation. Both India and Ethiopia have suffered high rates of open defecation, associated with frequent diarrhea and slower growth among young children.
India's ambitious plans to achieve sanitation for all must go beyond the construction of individual bathrooms.
Indian governments have tried to fight against the practice by building bathrooms. As part of Swachh Bharat's last campaign (Clean India), millions of new latrines have been built.
But many Indian families refuse to use the bathrooms, often for reasons related to caste. Sanitation work in India has traditionally been reserved for the lower caste ("untouchable"), as a result, many people from other castes are not willing to clean or empty their own toilets and prefer to defecate outside.
Unlike the government of India, the Ethiopian government addressed open defecation as a public health problem and focused on providing education on hygiene and sanitation. The approach was widely praised by WHO, as Ethiopia reduced the rates of open defecation from 92% in 1990 to 29% in 2015.
The reduction of India in that period of time was much smaller, from 70% to 46%. But even in the most recent sanitation campaign, the government of India devoted only 1% of the campaign's budget to providing sanitation education to the communities.
India sees itself as an emerging world power, but doubts persist about the direction of its development. The global image of the country would undoubtedly improve if it finally managed to overcome the enigma of South Asia and substantially improve its food security. Ethiopia's recent success in this regard indicates that focusing on nutrition and sanitation for pregnant women and young children may be the most effective way forward.