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Background and aims: The differences in prevalence of malnutrition are mostly on account of social factors. However, we did not find any published study that provided an estimate of proportion of stunting and underweight among under-5 children due to household economic conditions, social inequalities, mother's BMI and education level. Hence, study has taken to study the effect of household economic status, social inequality, mother's BMI and education on stunting and underweight among children under-5 years and its determinants.
Results: The prevalence of stunting and underweight children was significantly higher among those born to underweight mothers, poor households, working women, and women had a home delivery. It was also high among children of 4th or higher birth order, those from scheduled castes and tribes, born to illiterate women and those residing in rural. The odds of stunting (OR = 2.67, 95% CI: 2.54-2.81) and underweight (OR = 2.74, 95% CI: 2.60-2.88) were more than two times higher among children living in poor households than among those from rich households. Poor households account for about 40% of stunted and underweight children. Fifteen percent of stunted children and 26.9% of underweight were born to underweight mothers. Overall, 60% of stunted and 56.6% of underweight children had illiterate mothers.
Conclusions: children of illiterate and underweight mothers, socially deprived and economically poor groups are at a higher risk of being stunted and underweight. Hence, necessary health programmes are needed for improving nutritional status by giving special attention to illiterate, underweight mothers, socially deprived and economically poor groups.
India is suddenly in the news for all the wrong reasons. It is now hitting the headlines as one of the most unequal countries in the world, whether one measures inequality on the basis of income or wealth.
1. Progressive taxation, where corporations and the richest individuals pay more to the state in order to redistribute resources across society, is key. The role of taxation in reducing inequality has been clearly documented in OECD and developing countries. Tax can play a progressive role, or a regressive one, depending on the policy choices of the government.
Two key indicators are: how much has a government committed to spend on education, health and social protection? And how progressive are the spending levels? This chart shows the money India has spent on public services over the past eight years; the horizontal lines represent expenditure as a percentage of GDP, and vertical bars expenditure in rupees.
According to a forthcoming Oxfam report (to be published in 2017), India performs relatively poorly on both counts. Its total tax effort, currently at 16.7% of GDP, is low (about 53% of its potential) and the tax structure is not very progressive since direct taxes account for only a third of total taxes. South Africa, by comparison, raises 27.4% of GDP as taxes, 50% of which are direct taxes.
Oxfam has calculated that if India stops inequality from rising further, it could end extreme poverty for 90 million people by 2019. If it goes further and reduces inequality by 36%, it could virtually eliminate extreme poverty.
The Indian constitution secures the rights of the Scheduled Castes (SC), Scheduled Tribes (ST) and Other Backward Class (OBC) through a caste-based reservation quota, by virtue of which a certain portion of higher-education admissions, public sector jobs, political or legislative representations, are reserved for them. Despite this, there is a notable earning inequality between these social categories and the rest of the population, who consists of no more than 30% to 35% of Indian population. Adopting a data-driven approach we find that, on average, SC, ST and OBC still earn less than the rest.
Given the complicated intertwining of various forms of hierarchy in India, broad policies targeting inequality may have less success than anticipated. Dozens of factors other than caste, gender or family background feed into inequality, including home sanitation, school facilities, domestic violence, access to basic infrastructure such as electricity, water or healthcare, crime rates, political stability of the locality, environmental risks and many more.
Created in 2007 to help accelerate and share scientific knowledge on key societal issues, the AXA Research Fund has supported nearly 700 projects around the world conducted by researchers in 38 countries. To learn more, visit the site of the AXA Research Fund or follow on Twitter @AXAResearchFund.
The report stated that while poverty has decreased, "inequality has significantly increased, especially since 2000". "This trend has been in contrast with the dynamics globally and in other emerging economies," the report noted.
As per the report, the rise in inequality has been most pronounced in urban areas. "Inequality seems largely driven by rising wealth and income at the very top of the urban society of India," the report said. On the overall measure of social progress, India ranks 115th among 163 countries slightly below its GDP per capita ranking.
India has been one of the global leaders in sustained prosperity growth - only China, Myanmar, Vietnam, and Lao have, over the last three decades, achieved higher and more stable prosperity growth - the nation still faces significant poverty. "Approximately 20 per cent of its population is below the poverty line. But the absolute number of poor people in India remains large, with 95 per cent of the population classified as either poor or low income," it stated.
"Indian women have made large gains in education and now have enrollment rates at all levels that are higher than men. But there are still 186 million women who are unable to read or write a simple sentence in any language, and the female literacy rate is at 65 per cent, more than 15 per cent-points behind men," the report noted.
In addition, the report mentioned that Indian women have also seen their life expectancy move above men, and the mortality rate of girls below five years of age has dropped to a level only slightly above boys. "Women continue to have lower access to health care, and the share of girls in newborns is five per cent below biological norms."
India's average level of prosperity is not matched by its social progress, the report added. "Those components affecting the quality of life that are not directly related to GDP. Again, government policy has indeed targeted 'Ease of Living' but the data so far shows India both lagging behind in prosperity on overall social progress, and specifically on areas related to environmental quality, health care, and inclusion."
What is more disturbing is that the production of sanitary napkins has been constrained to a very large extent due to the lockdown and movement restrictions still operational in states like Jharkhand and Maharashtra. The availability of menstrual hygiene products, which also includes disposable and reusable sanitary pads, is highly unstable even in the most developed cities and almost negligible in rural areas located far from prime supply centres. Women who could afford the pads at their normal prices still fail to get hold of them due to the lack of public transport and mobility restrictions under the lockdown as well as the inflated prices caused by stocking and black marketing.
Menstrual hygiene education is a taboo in India. Women find it difficult to openly ask for sanitary products from a male family member (who generally fetch goods from the market). Women, especially in rural areas, are confined to their homes and depend on male or elderly female household members for procuring sanitary products.
The COVID-19 crisis has exposed the social divide that exists in India even today. Even after all these years, the Indian society still carries the patriarchal mind-set as a result of which there is a disparity between the status of a man and a woman. On one hand, men are considered independent and bread earners of the family, on the other hand women are seen as dependents whose primary duty is to look after the household. As a result of this, women fail to achieve economic independence, which make them rely on men for procuring sanitary products, which have become even more expensive owing to the shortage in their supply. This economic subduing coupled with the absence of gender equality which lets the male assume the dominating role in family, making women needs completely dependent of men.
The discrimination does not end here as economic status has a major role to play as well. The gender inequality is a major concern, but so is the economic divide that exists between women. While on one hand, the elite class women have the ease of getting their sanitary products delivered to their doorsteps, while on the other hand the poor and down trodden still struggle to make their ends meet when it comes to basic sanitation products. The gender and economic divide has led to subduing of women, especially those from marginalized or rural communities, that they lack access to education and in absence of awareness programmes maintaining sanitation for them becomes a luxury.
The failure of the government to broadcast sanitation awareness programmes or to include sanitary products as essentials in the first place reflects the continuous neglect of women and their basic sanitary needs in India. Though, the government included sanitary pads as essentials, nothing was done to balance demand and supply disruptions. Further, no efforts were made to open centres for providing sanitary pads to replace schools as distributors. Such a discriminatory approach towards women and their requirements need to be brought to an immediate halt.
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