The Nutrition-Hygiene Link

Context: National monetisation pipeline ignores contemporary challenges of pandemics, global warming and social unrest and is blinkered to structural problems of state-owned enterprises.

Rising nutritional insecurity

• A recent UNICEF report stated that nearly 12 lakh children could die in low-income countries in the next six months due to a decrease in routine health services and an increase in wasting. Nearly three lakh such children would be from India.
• The National Family Health Survey (NFHS 5) indicates that since the onset of the pandemic, acute undernourishment in children below the age of five has worsened, with one in every three children suffering from chronic malnourishment.
• According to the latest data, 37.9 % of children under five are stunted, and 20.8 % are wasted — a form of malnutrition in which children are too thin for their height.
• This is much higher than in other developing countries where, on average, 25 % of children suffer from stunting, and 8.9 % are wasted.

Relation between sanitation and malnutrition: While the inadequate dietary  requirement is considered the primary causes of malnutrition, contaminated drinking water, poor sanitation, and  unhygienic living conditions are alternative factors:

• According to the World Health Organisation, 50 % of all mal- and undernutrition can be traced to diarrhoea and intestinal worm infections, which are a direct result of poor water, sanitation and hygiene.
• Poor hygiene and sanitation lead to a sub-clinical condition called “environmental enteropathy” in children, which causes nutritional malabsorption and is the source of a variety of problems, including diarrhoea, retarded growth and stunting.
• The Convention on the Rights of the Child in 1989 urges states to ensure “adequate nutritious foods and clean drinking water” to combat disease and malnutrition.
• According to NFHS 4, approximately 9 % of children under five years of age in India experience diarrhoea.
• WHO has estimated that access to proper water, hygiene and sanitation can prevent the deaths of at least 8,60,000 children a year caused by undernutrition.

Way Forward

• Simultaneous approach to nutrition and WASH (water, sanitation, and hygiene): This will require a coordinated, multisectoral approach among the health, water, sanitation, and hygiene bodies, and community engagement. 
• This will serve to tackle the problem of mal- and undernutrition from the ground up, building awareness and accelerating the implementation of clean and safe living strategies.