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National Food Security Act: Overlooking the Poverty-Nutrition Nexus

Part II: Intergenerational Transfers and a Misconstrued Focus on Hunger


- Sregurupriya Ayappan*



Introduction

In the last post, I explored how the National Food Security Act [hereinafter “the Act”] insufficiently addressed the issues of maternal and foetal malnutrition as well as the nutritional practices in the critical growth period of the infant. I traced the reason for this to be the lack of understanding of the interrelationship between poverty and nutrition that is reflected in the provisions of the Act. In this post, I shall attempt to explore that argument in a different dimension. In order to do so, I shall use the concept of ‘structural poverty’ which is instrumental in understanding this interrelationship. Chronic poverty with a long durational aspect which persists and self-perpetuates through intergenerational transfers can be called ‘structural poverty’.[1] This is evidenced by certain communities which seem unable to escape the poverty trap despite interventions.[2]


I shall argue that undernutrition has long term effects on the body which reduces capabilities and makes it harder to escape the poverty trap as the cycle continues to the next generation through intergenerational transfer of undernutrition. Further, I shall argue that there is a difference between ‘hunger’ and ‘nutrition’ and the Act has a misconstrued focus on the former which is a huge obstacle to overcome in solving food insecurity in the country.


Undernutrition and its debilitating effects

The most obvious impact of undernutrition is on physical growth. However, it is far more insidious and goes on to adversely affect the capability set of the malnourished individuals cutting across generations. Undernutrition is associated with increased child mortality, complications during childbirth, child stunting and low birthweight. There is a positive correlation between low birth weights across generations and short statures in women. A woman born as “small for gestational age”, that is, has stunted height and body composition at birth, is at a much higher risk of giving birth to a child who is “small for gestational age.” Studies show that several generations of integrated intervention are needed to undo such effects of undernutrition.[3]


This implies that children who are born to malnourished women are at a high risk of being malnourished themselves. Further, such children grow up in an environment where other family members, at the very least the mother and siblings, too suffer from the setbacks caused by malnutrition. Oftentimes, the intersectionality of poverty ensures that the entire community is similarly affected which negatively impacts child development. This not only affects the physical growth of the child but also includes behavioural developmental aspects leading to competence[4] and the ability to escape poverty.


According to Wachs, there are five domains of competence: namely, cognitive skills, personality, motivation, self-perception and interpersonal style. The acquisition of competence is influenced by nutritional, genetic, environmental and cultural factors.[5] Here, it must be noted that chronic poverty reflects an intersectionality of lack of access or access to poor nutrition, environment and culture, and in turn, genes. Health and nutrition are elements of intergenerational transfers and happen through private[6] and public channels[7] in addition to familial transfers.[8] Thus, sadly, undernutrition results in negative intergenerational transfers[9] and reduces competence.[10]


There is yet another way in which undernutrition in childhood negatively impacts life in the long run. It causes the double problem of malnutrition where the body becomes accustomed to its earlier dietary regime and any changes at a later stage increase the risk of developing non-communicable diseases like obesity and hypertension among others.[11] This affects the quality of life even after the person manages to break out of poverty.


The nearly inescapable poverty trap

Having explored the concept of intergenerational transfers, it is now evident that poverty (and undernutrition) is cyclical in nature and are propelled into continuing due to both genetic and sociocultural factors. Other factors which are concomitants of poverty, such as the inability to interact with a more diverse set of people, experiences and ideas, confine the genetic pool ensuring the vicious cycle of negative transfers. The figure below explains this in a succinct manner.



Figure 1: Nutrition Cycle and IGT[12]



In order to disrupt this cycle, there must be a concerted effort at every stage to provide adequate nutrition to these individuals. However, unfortunately, a major problem which plagues the Act is that it focuses on curing “hunger” to take care of “nutrition” by focussing on satiation. It reflects a severe lack of understanding of the difference between these concepts. Hunger can be defined as “a condition, in which people lack the basic food intake to provide them with the energy and nutrients for fully productive lives.”[13] While increased food intake can relieve hunger through providing macronutrients such as calories and proteins, it does not relieve all forms of malnutrition. Macro and micronutrient deficiency continues to be the dominant nutritional problem in developing countries.[14] Hence, it is important for the law to reflect the distinction between the two. It is essential that there is intervention at the level of constructing knowledge and perceptions of those who suffer the most in order to change certain determinants[15] of intergenerational transfer. One way to do this would be to have a legal definition of “nutrition” in the Act itself. However, unlike the draft Bill prepared by the National Advisory Council in 2011, the Act does not even define the term “nutrition” although it seeks to provide for “food and nutritional security.”


The implications of this lack of clarity are reflected in the ground realities as there have been little to no signs of major improvement in the nutritional status in the country over time. Although statistics show that extreme hunger and severe undernutrition have been on a steady decline, the progression of anthropometric indicators like height and weight of children is very poor.[16]


If the Act is supposed to meet its objectives, there must first be a clear demarcation between food and nutrition where the latter is defined.[17] Schedule II which prescribes ‘nutritional’ standards only specifies the calorific value and the protein content required. Further, even these are much below what is required to break the cycle of undernourishment. The nutritional standards must be amended to reflect a more detailed split-up.


Currently, barring the ICDS programme, there is no integration with any other existing programmes. It is imperative that food and nutrition initiatives are intertwined with poverty-alleviation efforts. This is because poverty is both a ‘cause’ and an ‘effect’ of malnutrition. Only when both are tackled together, can individuals and communities break free from the vicious poverty-malnutrition cycle.


Another major cause for undernutrition is the low quality of staple-food diets which might provide sufficient calorific content but insufficient micronutrients in economically weak households.[18] While there is mandatory fortification of salt with iodine,[19] there is no fortification of staple foods with micronutrients. They only remain as pilot projects in Gujarat and West Bengal where state wide wheat flour fortification programs were implemented and still continue in the latter through the Public Distribution System.[20] The Act should include a mandatory food fortification programme. Instead of focussing on wheat and rice, it would be more beneficial to use more nutrient rich millets.[21] Lessons must be learnt from countries like South Africa where there is mandatory fortification of maize and bread flour with a mineral and vitamin mix based on analysis of existing intakes and needs of the children population.[22]


Conclusion

While the Act as it stands seems inadequate in many respects and the implications of structural poverty paints a dismal picture for nutrition in the country, it must be kept in mind that poverty dynamics and intergenerational transfers are temporal. People can move in and out of poverty over time. With concerted efforts throughout the life cycle of people and a focus on nutrition security along with food security, it is possible to break free from this vicious cycle. The slight modifications to the legislation and the general recommendations that have been made could help better the scenario to a certain extent.



*Sregurupriya Ayappan is a third year student at the National Law School of India University, Bangalore.



[1] David Hulme & Andrew Shepherd, Conceptualising Chronic Poverty, World Development (2003).


[2] Jean Dreze, Democracy and the Right to Food, 4(1) Economic and Political Weekly, 1723 (2004). More deprived states like Jharkhand, Chhattisgarh, Orissa, and the more deprived regions within these poorer states and in them, the poorer communities like the sahariyas, musahars, kols, bhuiyas and other marginalised communities are in a statement of permanent nutritional emergency.


[3] Reynaldo Martorell & Amanda Zongrone, Intergenerational Influences on Child Growth and Undernutrition, 26(1) Pediatric and Perinatal Epidemiology, 302 (2012).


[4] T.D. Wachs, The Nature and Nurture of Child Development, 20(1) Food and Nutrition Bulletin, 7 (1999). Competence refers to effective adaptation and interaction with the environment.


[5] Id.


[6] An example of this could be adoption of a malnourished infant and adequate nutrition in the critical growth period and later.


[7] An example of this could be the Mid-day meal scheme.


[8] Karen Moore, Thinking about Youth Poverty through the Lenses of Chronic Poverty, Life-course Poverty and Intergenerational Poverty, (Chronic Poverty Research Center, Working Paper 57, 2005).


[9] In terms of human, sociocultural, socio-political, financial, material, environmental capital.


[10] Andy Sumner et al, Rethinking Intergeneration Transmissions: Will a Wellbeing Lens Help? The Case of Nutrition, 40(1) Institute of Development Studies Bulletin (2009).


[11] Hester Vorster, The Link between Poverty and Malnutrition: a South African Perspective, 15(1) Journal of Interdisciplinary Health Sciences, 6 (2010).


[12] Kate Bird, The Intergenerational Transmission of Poverty: An Overview (Chronic Poverty Research Centre, Working Paper 99, 2007)


[13] Hunger Task Force, Annual Report (2003).


[14] Jehr Behrman et al, Hunger and Malnutrition, Copenhagen Consensus (2004). For example, someone who consumes even 5000 calories a day clearly does not suffer from hunger. However, if the food is rich in carbohydrate and fats, and devoid of any protein or micronutrients, the person will still suffer from undernutrition or malnutrition. In other words, hunger is centred around the quantity of food while nutrition focuses on the quality of food. Merely solving the hunger problem will not help improve the capability set of a person.


[15] If there is a difference between the dietary beliefs of the people, like ‘eating down’, and what the law seeks to promote, there will be implementational failure.


[16] Dreze, supra note 3.


[17] In light of the difference between hunger and malnutrition, and the object of the act being “ensuring adequate quantity of quality food”, the lack of definition of nutrition in the Act has led to a conflation of quantity and quality.


[18] Vorster, supra note 11.


[19] Food Safety and Standards (Fortification of Foods) Regulation, 2016.


[20] Sameen Almas and Garima Sharma, Proceedings of the National Summit for Food Fortification, Food Safety and Standards Authority of India Report (October 2016).


[21] P.P. Rao et al, Diagnostics of Sorghum and Pearl Millet grains based nutrition in India, 47 International Sorghum and Millets Newsletter, 93 (2006).


[22] Vorster, supra note 11.

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