Non-vegetarian food consumers have increased in India, including in Bharatiya Janata Party (BJP)-ruled states like Gujarat, Uttar Pradesh and Madhya Pradesh, as per data released by the recent National Family Health Survey-5 (NFHS-5).

This is significant because right-wing supremacists have been peddling the fase narrative that non-vegetarians are a small minority in India. In fact, it is based on this false narrative that state administrations have attempted to remove eggs from mid-day meal plans, and non-veg food vendors from the streets. However, latest health data shows that more people are joining an already significant non-vegetarian population.

Groups across India were surveyed from 2019 to 2021 owing to the Covid-19 pandemic. However, compared to the 10-year gap between NFHS-3 and NFHS-4, the recent report was published only after a gap of five years.

More meat-lovers in Gujarat

As per the data, non-veg eaters in BJP-led Gujarat increased by at least seven percentage points over five years. As many as 39 percent of 33,343 surveyed women and 51 percent of 4,957 surveyed men confirmed eating fish or chicken or similar meat. These percentages are higher than the NFHS-4 data (2015-16) when 30.8 percent of 22,932 surveyed women and 43.5 percent of 5,567 surveyed men said they consumed non-veg.

Moreover, by 2019-21, 2.4 percent women (around 800 people) and 2.1 percent men (104 people) consumed such non-vegetarian food daily. Another 17.8 percent women (5,935 people) and 18.5 percent men (917 people) ate the food weekly, while 18.6 percent women (6,208 people) and 30.3 percent men (1,502 people) ate it occasionally.

In terms of egg consumption, 37.9 percent women (12,637 people) and 52.1 percent men (2,583 people) in 2019-21 said they consumed eggs – be it daily, weekly or occasionally. Again, this is more than the 2015-16 data that said 31.2 percent women (7,155 people) and 46.3 percent men (2,578 people) eat eggs.

In November 2021, the Ahmedabad Municipal Corporation (AMC) tried to ban the sale of non-veg food on city streets. Other cities like Vadodara, Bhavnagar, Rajkot also tried to ban the sale of these ready-to-eat items. Officials claimed that non-vegetarian food on streets creates a health hazard because such food is “unhygienic and harmful to the environment”. However, the Gujarat High Court came down heavily upon the AMC for taking such actions against street vendors challenging its authority from curbing people’s right to eat.

Maharashtra’s non-vegetarians continue to grow in number

Maharashtra too showed a gradual increase in the number of non-veg eaters. After surveying 33,755 women and 5,048 men, the NFHS-5 data said that 71.8 percent women and 83.2 percent men confirmed consuming meat by 2019-21. The NFHS-4 data (2015-16) showed around 70 percent of 29,460 surveyed women and 81.9 percent of 4,497 surveyed men consumed non-veg. This shows that in a state where non-veg consumers are already in the majority, popularity for the food only continues to grow.

By 2019-21, 3.7 percent women (1,249 people) and 5.5 percent men (278 people) consumed such non-vegetarian food daily. Another 41.6 percent women (14,042 people) and 53.8 percent men (2,716 people) ate the food weekly, while 26.5 percent women (8,945 people) and 23.9 percent men (1,206 people) ate it occasionally.

Over half of MP eats non-veg food

In Madhya Pradesh, 53.6 percent of 48,410 surveyed women and 66 percent of 6,503 surveyed men confirmed eating fish or chicken or similar meat. Whereas, the NFHS-4 data (2015-16) showed 51.7 percent of 62,803 surveyed women and 68.6 percent of 9,510 surveyed men consumed non-veg. As is apparent, there is a glaring difference in the sample size for the two surveys. Thus, while the latest data may be nominal non-veg eaters account for over half the population.

The NFHS-5 report shows that at least 0.6 percent women (290 people) and 1.6 percent men (104 people) consumed such non-vegetarian food daily. Another 14.3 percent women (6,923 people) and 23.7 percent men (1,541 people) ate the food weekly, while 27.2 percent women (13,168 people) and 35.3 percent men (2,296 people) ate it occasionally.

In terms of egg, 47.7 percent women (23,092 people) and 65.6 percent men (4,266 people) in 2019-21 said they consumed eggs be it daily, weekly or occasionally. This is relatively the same as NFHS-4 data when 47.4 percent women (29,768 people) and 65.9 percent men (6,267 people) consumed eggs in 2015-16.

Egg consumption remains a controversial topic in MP, as the majority claims to have a largely vegetarian cuisine. The issue extends to mid-day meal plans offered to children from families, who struggle to provide food for their off-springs. Many nutritional experts have pushed the inclusion of eggs in the plan for proper-development of children, especially after the Covid-19 pandemic.

UP not far behind

Despite a five-year difference, Uttar Pradesh reported relatively static progression in terms of non-vegetarian consumption. As per the report, 53.6 percent of 93,124 surveyed women and 66 percent of 11,157 surveyed men confirmed eating fish or chicken or similar meat. Meanwhile, the NFHS-4 data (2015-16) showed 51.7 percent of 97,661 surveyed women and 68.6 percent of 12,946 surveyed men consumed non-veg.

Latest data said that 0.8 percent women (745 people) and 2.2 percent men (245 people) consumed such non-vegetarian food daily. Another 19 percent women (17,694 people) and 28 percent men (3,124 people) ate the food weekly while 33.8 percent women (31,476 people) and 35.8 percent men (3,994 people) ate it occasionally.

In terms of egg, 59.6 percent women (55,502 people) and 73.8 percent men (8,234 people) in 2019-21 said they consumed eggs be it daily, weekly or occasionally. This is relatively the same as NFHS-4 data when 56.2 percent women (54,885 people) and 74.5 percent men (9,645 people) ate eggs in 2015-16.

Concerns persist in Karnataka

The NFHS-5 data for the southern state accounted for 2019-20 alone. It said that 77.6 percent of 30,455 surveyed women and 85.4 percent of 4,120 surveyed men confirmed eating fish or chicken or similar meat. This is lower than the NFHS-4 data (2015-16) that showed 80.3 percent of 26,291 surveyed women and 86.5 percent of 3,743 surveyed men.

Recently, members of the Lingayat community demanded that the state government serve “pure vegetarian” meals in government schools. However, the children were the first to reject this and said they want the boiled eggs three times a week. Still, around December 2021 the government began to ‘explore’ alternatives to boiled eggs in mid-day meal plans.

In terms of egg-intake, 82.2 percent women (25,034 people) and 89.6 percent men (3,692 people) in 2019-20 said they consumed eggs be it daily, weekly or occasionally. This is relatively the same as NFHS-4 data when 82.9 percent women (21,795 people) and 90.1 percent men (3,372 people) ate eggs in 2015-16.

As for fish, chicken and other non-veg items, 5.5 percent women (1,675 people) and 7.3 percent men (301 people) in 2019-21 said they consumed the food daily. Another 52.2 percent women (15,898 people) and 52.8 percent men (2,175 people) ate the food weekly, while 19.9 percent women (6,061 people) and 25.3 percent men (1,042 people) ate it occasionally.

The data may be viewed here:

http://rchiips.org/nfhs/NFHS-5_State_Report.shtml

http://rchiips.org/nfhs/NFHS-4Report.shtml

An Indian Express analysis report recently looked at NFHS-5’s nationwide data and said that there’s a 5-percentage-point drop in the proportion of men aged 15-49 years who have never consumed non-vegetarian food. The data stood at 16.6 percent men in 2019-21 and 21.6 percent men in NFHS-4. However, the proportion of women in the same age group remained relatively stable between 29.4 percent women in 2019-21 and 29.9 percent women of 2015-16.

Related:

Meat sale banned in Ghaziabad, demands brew for a repeat in MP
Allahabad HC bats for tolerance, but refuses to strike down meat and liquor sale ban
Understanding the layers of “hate” in Gujarat’s non-veg ban
Why does the Karnataka government not want children to eat eggs at mid day meals?

The post NFHS-5 data busts right-wing myth of Indian vegetarianism appeared first on SabrangIndia.

Afsana Bano studied to class 12, among only 16% of women with more than 10 years of education in Uttar Pradesh’s Sitapur district. Yet, she is an underweight mother with an underweight child, ignorant of the health needs of both. Bano and her 2.6-kg child represent the failure of government adolescent, sexual health services in the state.

Bano’s situation is representative of a cycle that keeps millions of Indian mothers and children, particularly in the most populous, poorest states, undernourished and incapable of learning and earning enough, thus holding back Indian economic progress, according to several research studies.

Bano was 18 when she married and was underweight when she conceived, weighing 51 kg in the eighth month of pregnancy, gaining no more than 200 gm by the ninth. She did not think much of it because she was unaware of the consequences of an underweight child.

Studying till class 12, Bano had an above-average education in rural Sitapur, where no more than 16.4% of women have had 10 years of education, compared to 32.9% in UP and 35.7% nationwide. But she never got the attention or counselling that the government health system was supposed to give her.

This is particularly important in Sitapur, where 36% of married women are adolescents, according to the 2015-16 National Family Health Survey (NFHS)–or NFHS-4–data, compared to an average of 21% in Uttar Pradesh (UP), India’s most populous and third-poorest state, by per capita income, and 27% nationwide.

With 4.4 million people, Sitapur is classified as one of 25 “high priority districts” across Uttar Pradesh and 184 across India identified for special attention to pare child marriage and adolescent pregnancies.

But the programme to address early marriage and teenage pregnancy, the Rashtriya Kishor Swasthya Karyakram (RKSK), a five-year-old national youth health programme, was given 1% of National Health Mission (NHM) funding in Sitapur, falling over a year from 3% in 2016-17.

Of this money a third was never spent, according to a 2019 analysis of NHM finances by Accountability Initiative, a think tank based in New Delhi, although there has been some improvement, as we explain later.

Source: Accountability Initiative, 2019 ((Data shared with IndiaSpend)

The failure of the RKSK to meet its ambitions of widening attention to adolescent sexual health and incorporating those needs into wider health programmes and effect change was acknowledged by a government spokesperson.

“The inherent problem with the programme is that the RKSK is seen as a low-priority component in NHM,” Sujit Verma, NHM’s district programme manager in Sitapur, told IndiaSpend. “The kind of demand institutional deliveries, leprosy, tuberculosis programmes have is not felt by RKSK.” The community does not consider adolescent health issues as important enough to be discussed in a hospital, he added.

“Handholding of ASHAs (accredited social health activists) and peer educators is required to develop a demand that stems from the community,” said Verma.

Developing the ‘demand’

With Bano and Sitapur, that demand has obviously not materialised. Developing the demand, as Verma put it, has wider implications.

Preventing malnutrition of children and women in what experts call a “crucial” 1,000-day window–from the start of a woman’s pregnancy to her child’s second birthday–could boost India’s gross domestic product by between $15-46 billion (Rs 1.03 lakh crore to Rs 3.17 lakh crore), according to 2013 report by Save the Children, a global advocacy. That is six times the size of India’s 2018-19 health budget.

Bano’s situation is representative of many women in Sitapur, where child marriage and early pregnancy are endemic, said experts: 7.3% of women in Sitapur between 15-19 years already are mothers, according to NFHS-4 data. Even though teenage childbearing in UP is half (3.8%) India’s average (7.9%), in Sitapur 35.5% of women are married before they turn 18, higher than the UP average of 21% and the Indian average of 27%.

It took India 19 years to bring down child marriages by 51%, according to the Global Childhood Report by Save the Children. If those numbers to fall further, adolescent health in rural areas requires immediate attention. That may be difficult without adequate data.

“Not enough information is available on younger adolescents (10-14 years), and both younger and older adolescents’ needs to be assessed differently,” said Niranjan Saggurti, India country director, Population Council, a global research organisation. “One can then get more clarity as to which adolescents are most at risk as regards reproductive health.”

Bano’s education did not prepare her for knowledge of sexual or health issues. She studied at  a madrasa, or Islamic seminary, and no health worker or health programme reached her mud-and-straw home in Parsendi village, 90 km north of the state capital Lucknow, as they were supposed to–and indeed do in India’s more prosperous states, such as Kerala. 

Bano’s husband, Mohammed Karim, 21, was in no position to advise her: he studied till class five and worked for awhile in a “tablet-making company”, as he put it.

Before pregnancy, Afsana visited the anganwadi–or government creche-cum-health centre–only once. The first time she visited was in the sixth month of pregnancy, which is three months later than recommended and only got one tetanus vaccination instead of the two she should have. She was given iron and calcium tablets, but they made her sick with diarrhoea, she said.

Bano never visited the anganwadi again.

The malnourishment cycle

There is every chance Bano’s child will grow up malnourished, as children of underweight mothers tend to be, and be less educated and productive than he might be.

Malnutrition is one of the leading causes of about half of India’s childhood deaths, and if they are affected at an early age, there can be long-term consequences, affecting motor, sensory, cognitive, social and emotional development. States with more educated women had healthier children, according to a March 2017 IndiaSpend analysis of NFHS-4 data.

While India’s burden of disease due to child and maternal malnutrition has been decreasing since 1990, malnutrition was responsible for 15% of the total disease burden in India in 2016, according to India: Health of the Nation’s States, a report produced by independent medical agencies, nonprofits and the government.

Nationally, there was a 9.6-percentage-point reduction in the stunting rate of children in 2015-16 compared to a decade before that. UP’s improvement rate was 10.5 percentage points, according to our analysis of NFHS data.

Home to almost a third of the world’s stunted children under five (46.6 million), India is not on track to reach the World Health Organization’s (WHO) 2025 global nutrition targets, IndiaSpend reported in January 2019.

Of Indian children under two years of age, 90.4% did not receive an adequate diet, according to NFHS-4 data. About 18% of children aged 6-23 months ate iron-rich foods, and more than half the children in this age group were anaemic. About 54% consumed vitamin A-rich foods, the lack of which can lead to childhood blindness and poor immunity.

To address this situation, government health services must go to the root of the problem: the mothers. That is not easy to address, said experts, when the mothers are adolescents.

Why adolescent health matters

Adolescent health is the most critical stage in life for health interventions, according to expert advice.

“More than 33% of the disease burden and almost 60% of premature deaths among adults can be associated with behaviours or conditions that begin or occur during adolescence,” said a 2002 WHO statement.

The health of adolescent girls and young women is linked to the birth weight of the children and to child survival. Adolescent mothers become more vulnerable to problems related to pregnancy and childbearing and are more likely to have premature and underweight babies.

High maternal and child mortality in adolescent mothers and a smaller but significant contribution of adolescents to the total fertility rate (TFR) or the number of children that a woman has. UP’s TFR is 3.1, compared to 1.8 in Kerala, 1.6 in Tamil Nadu and 1.6 in West Bengal, compared to the replacement rate of 2.1, at which point population stays the same.

These data illustrate the need to make adolescent health a part of overall maternal and child health, according to a 2014 adolescent-health strategy paper from India’s ministry of health and family welfare.

RKSK in UP: Noble aims, slow spending

Launched in 2014, the RKSK was the first programme to place adolescent health at the centrestage of government health priorities.

The RKSK subsequently widened its scope from sexual and reproductive health to include nutrition, non-communicable diseases and substance abuse and has since shifted its focus from curative to preventive and aims to reach adolescents in their own environment.

These aims have not yet been met in Sitapur, where the training of what are called “peer educators”, specially trained teens aged 15 to 19 from every village, was envisaged as in the other 24 “high-priority districts”. Each of these districts was also supposed to have an adolescent friendly health centre and a counsellor.

In reality, both the RKSK and the NHM struggle to even spend the money they get.

A little more than half (55%) of NHM funds were used in UP in 2017-18, although this is an improvement from 45% in 2016-17, and, as we said, RKSK expenditure as a proportion of NMH spending fell from 3% in 2016-17 to 1% in 2017-18.

Sitapur was given Rs 1.72 crore in 2018-19 for RKSK, up from Rs 1.42 crore in 2017-18, an increase of 21%. The use of these funds increased from 41% in 2017-18 to 45% in 2018-19. 

Source: Accountability Initiative, 2019 (Data shared with IndiaSpend)

“Sitapur reflects a clear low utilisation story; despite the money allocated, districts are not receiving the full amount that’s being allocated to them,” said a researcher who has worked on sexual health issues but requested anonymity because she worked with the government. “Funds are normally released only in the last two quarters, which is also why most of the funds go unused.”

On the issue of a lack of demand for adolescent health services, the researcher said that most of the expenditure in RKSK is not based on demand and was spent on training frontline workers, such as the ASHAs and peer educators.

Back in Parsendi, Bano said she lived a happy life with her husband, with whom she had fallen in love, a rare culmination to a teenage romance in a society where arranged marriages are the norm. She wanted to study further. How would she do it now that she had a child? Bano only smiled. 

Correction: The story has been corrected to reflect that the estimated boost to India’s gross domestic product due to prevention of malnutrition is six times the 2018-19 health budget. We regret the error.

(Ali is a reporter with IndiaSpend.)

Courtesy: India Spend

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