FOOD, HEALTH AND SURVIVAL IN INDIA AND DEVELOPING COUNTRIES Stuart Gillespie and Geraldine McNeill Publisher: Oxford University Press, Delhi Price:
IT IS A daring and formidable task to synthesise the insights of social and physical anthropology, physiology, epidemiology, micro-economics and macro-economics. This has been attempted with considerable success in this book by focussing primarily on survival strategies of rural households in "developing" countries in the face of both chronic and acute imbalance in food entitlements on the one hand and energy requirements on the other.
The structure of the food system is discussed in the introduction at both analytical and descriptive levels. This is followed by a consideration of the nature and time patterns of "energy stress", felt at the level of the individual, the household and the social system as a whole. The individual and the households try to make different biological and behavioural adjustments to cope with the stress. The social system, by activating the state and non-state institutional structures, also try to meet the challenge. But in each case there are dilemmas of choice and the authors carefully take note of the them.
This book's leitmotif is the food-cycle. The nutritional status of individuals, whose social position has been identified by age, gender and socio-economic status of the households to which they belong, is used as the principal indicator of the operation of the system. A departure made by the authors from conventional approaches is the computation of the aggregate nutritional status of different categories of households and then analysing inter-household and intra-household energy stress differentials, with reference to parameters like participation in working force, seasonal variation in labour intensity, in addition to gender, age, production-relations, socio-economic status and occupation. While the empirical materials have been drawn mainly from case studies carried out in two south Indian villages, comparable materials from rural societies in several "developing" countries have also been provided.
Three main clusters of causes of nutritional deprivation have been identified in this book: inadequate household food entitlement, lack of women's control over resources and malnutrition-infection complex.
Food entitlement refers essentially to a household's command over food, achieved either through growing food or by working for wages with which to buy food. But ensuring household-level food entitlement is often not sufficient to ensure adequate nutrition of its individual members. Control over resources by women determines to some extent how income and food is allocated within the household. Certain individuals may be discriminated against in terms of allocation of food or health care. The trade- off in ensuring household food security may also be reduced maternal time available for child care and feeding. Again, while a household may have access to food, levels of environmental sanitation may be low, resulting in high exposure of individuals to disease. Knowledge of disease management may also be lacking. Cumulatively, all these may make individuals prone to the malnutrition-infection complex.
It follows that for nutrition-relevant actions to be effective, both public involvement and appropriate, technical, policy instruments are required. Based on the work of economists Jean Dreze and Amartya Sen, the authors suggest that democratisation is extremely relevant for achieving nutritional balance for the different sections of the population. Accountability and people's means of expressing needs and influencing their own situation through the political system may be crucial.
Public action, however, is not exclusively state action. It is not something done for the public, but crucially also by them. The technical policy instruments, as suggested in this book, span agriculture, employment, health, education, social welfare and the environment. The importance of underlying macro-level or sectoral actions as the backdrop of direct technical policy instruments is also recognised. For instance, the UNICEF has highlighted the adverse impact of many recent macro-economic adjustment programmes on vulnerable groups.
This is of particular relevance for India, which lately moved over to liberalisation policy from state regulated and sponsored production policies. In this connection, factors such as the openness of the economy, flexibility in the markets for foreign capital, nature of interest rate setting, the extent of indexing of wages, the level of import protection and export taxes and subsidies have been mentioned. Though a neutral stance has been maintained in the presentation of these factors, from the contextual setting one can feel a positive orientation towards the World Bank and IMF approach. How one would take it depends on one's ideology.
But, methodologically, there is one major limitation of the book. Energy stress results not only from malnutrition but also from an excess intake of nutrients and many of the "developed" countries are underdeveloped in their perception of the problem. In moving towards a world-system perspective the appraisal and the analysis should not be confined to the "developing countries", but should also cover the so-called "developed" countries.
B K Roy Burman is visiting senior fellow at the Centre for Study of Developing Societies, Delhi.
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