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‘Not All Women’s Health Is About Maternal Health’

We need to expand the scope for care for women's health to include issues beyond maternal health, says Dipa Sinha, economist and core group member of the National Human Rights Commission's Right to Food, in this interview.

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Women's health

Dipa Sinha, economist and core group member of the National Human Rights Commission's Right to Food | We need to expand the scope for care for women's health to include issues beyond maternal health, says Dipa Sinha | Photo courtesy: Special arrangement, IndiaSpend

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Women’s well being, estimated from their Body Mass Index (BMI), education, early marriage and access to antenatal care, could explain half of the difference between high and low stunting rates in India, a 2018 study by the International Food Policy Research Institute showed. Investments in women’s health and nutrition, therefore, have intergenerational impacts.

Poor nutrition, which directly causes malnutrition, has many underlying causes--poverty, of course, but also lack of education, poor sanitation, low quality of health services and ineffective nutrition programmes, IndiaSpend reported in July 2018.

Women also face several health problems that have nothing to do with their reproductive health that require attention from policymakers. In addition, they continue to face disparities in terms of access and treatment, spending less time in a hospital for all kinds of diseases and also less money on treatment compared to men.

About 13.5% of Indian women aged 15 and above are diabetic, while 21.3% of them have hypertension, as per the fifth National Family Health Survey, 2019-20 (NFHS-5). In addition, about 57% of them are anaemic, an increase from 53% in 2015-16.

To improve women’s health, we need to focus on these social determinants of health including providing access to adequate nutrition, sanitation, as well as by providing employment and education to women, according to Dipa Sinha, assistant professor at the School of Liberal Studies, Ambedkar University, Delhi. Sinha is a member of the core group on Right to Food under the National Human Rights Commission.

As India elects the 18th Lok Sabha, we spoke with Sinha to evaluate the performance of various schemes, including nutrition schemes, over the past few years.

Excerpts from the Interview

According to the NFHS-5, 16% of Indian men and 19% women have low body mass indices, in addition to 32% children under five years having low weight for age, despite the country being self-sufficient in cereal production. How much has the system of disbursing food entitlements improved and what do we need to do to improve it further?

Malnutrition is an outcome of multiple factors. Food is very important, but there are a number of other factors like sanitation, care for the child, feeding practices, etc. that influences the nutrition status. In India, there are gaps in all of these, according to the data.

At present, the food programmes meet very basic food security requirements of the beneficiary households. The role of food as a determinant (of nutritional status) goes beyond satiating hunger. It is meant to provide adequate nutrition. For this, you need a diverse diet. Whatever little data we have on dietary diversity, the Indian cereal-based diets lack in several food groups. There is very little protein in Indian diets. Good quality protein, which is animal protein, is unaffordable, so a lot of people don't consume them on a regular basis. Fruits, vegetables, oils, etc. are not given through the public programmes. Their consumption depends on people's capacity to buy them from the market.

In addition, there are a number of issues like unemployment, livelihood security, etc. that affect food access. We look at food security not just from the point of view of rice and wheat--or roti and chawal--but actually appropriate diets that would improve nutrition. The public programme does not meet these requirements.

To a certain extent, the  mid-day meal and Integrated Child Development Services (ICDS) do give foods like vegetables and proteins, but when the cost of providing them increases, these schemes also end up giving mainly cereals.

The way the PDS can be improved is

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