Eleventh Five Year Plan

4Nutrition and Social Safety Net4.1 FOOD AND NUTRITIONINTRODUCTION4.1.1 At the beginning of the Eleventh Plan periodthere are serious concerns around food and nutritionalsecurity. Agriculture has performed well below expectationsduring the two recent Plans. Cereal productionhas declined in per capita terms. The number ofthe poor has barely declined by 20 million people overthree decades, 1973–2005, from 320 million to 300million; and most of this decline has occurred duringthe most recent decade (1993/94–2004/05). Low andstagnating incomes among the poor has meant thatlow purchasing power remains a serious constraintto household food and nutritional security, even iffood production picks up as a result of interventionsin agriculture and creation of rural infrastructure(discussed in Volume III).4.1.2 Outcomes in terms of protein-energy malnutrition(PEM) speak for themselves: in 1998–99, accordingto National Family Health Survey-2 (NFHS-2), asmuch as 36% of the adult population of India had abody mass index (BMI) below 18.5 (the cut-off foradult malnutrition); eight years later (2005–06) thatshare had barely fallen to 33% of the population, despitea decade of robust economic growth. Similarly,share of the under-weight children under-3 in thetotal child population under-3 had not fallen at all(47% in 1998–99 and 46% in 2004–05/06). There is aneed to look at food security issues not in isolation asbeing confined to cereal production and consumption,but to examine how nutritional outcomes can beimproved for the vast majority of the poor.4.1.3 Ensuring food and nutritional security, however,cannot be enough. There are far too many vulnerabilitiesin the lives of the poor and those just above thepoverty line. Around 93% of our labour force worksin the informal sector, without any form of social protection,especially against old age. With growingmigration of younger rural residents to urban andfast-growing rural areas, elderly parents are often leftbehind in the village to cope on their own, or aredependent upon women who also have to tend to thefamily farm, as agriculture feminizes with growing malemigration. Old-age pension is thus becoming a cryingneed for those dependent on insecure employment inthe informal economy as well as for parents left behind.Moreover, vulnerability in respect of health arises fromthe under-funding of the public health system and itsinability to provide comprehensive care, which is amajor concern for the majority of the population.MALNUTRITION: A CONCEPTUAL ANDEMPIRICAL ANALYSISSome Conceptual Issues4.1.4 Malnutrition reflects an imbalance of both macroand micro-nutrients that may be due to inappropriateintake and/or inefficient biological utilization due to theinternal/external environment. Poor feeding practices