[STUDY SAYS PREGNANT WOMEN IN INDIA ARE GRAVELY UNDERWEIGHT]
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Mothers and newborns at a
hospital in Gurgaon, India. A greater percentage
of Indian mothers are
underweight than are mothers in far poorer countries.
Credit Kuni Takahashi for
The New York Times
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NEW DELHI — Her first child survived eight months before
succumbing to pneumonia; her second was stillborn; her third, delivered in a
rickshaw, gasped for an hour before dying.
When she got pregnant for a fourth time, Juhi, a woman from a
South Delhi slum who uses only one name, was spotted by a local health worker
and taken to a mobile clinic. A doctor diagnosed severe anemia, gave her iron
pills and begged her to eat more.
Juhi listened, and gave birth to a boy, Muhammad Sultan, who has
survived his first birthday — a huge milestone in a country with about
one-sixth of the world’s population but one-third of all newborn deaths.
“My in-laws were telling me they would get my husband married to
someone else, because I couldn’t have a healthy baby,” Juhi, 26, said in an
interview. “That’s why we left our village. But now my mother-in-law is happy
with me.”
The poor health of children in India, even after decades of
robust economic growth, is one of the world’s most perplexing public health
issues.
A child raised in India is far more likely to be malnourished
than one from the Democratic Republic of Congo, Zimbabwe or Somalia, the
world’s poorest countries. Poor sanitationand a growing tide of drug-resistant
infections also affect nutrition.
But an important factor is the relatively poor health of young
Indian women. More than 90 percent of adolescent Indian girls are anemic, a
crucial measure of poor nutrition. And while researchers have long known that
Indian mothers tend to be less healthy than their African counterparts, a new
study published Monday in the Proceedings of the National Academy of Sciences
demonstrates that the disparity is far worse than previously believed.
By analyzing census data, Diane Coffey of Princeton University
found that 42 percent of Indian mothers are underweight. The figure for
sub-Saharan Africa is 16.5 percent.
Ms. Coffey calculated that the average woman in India weighs
less at the end of her pregnancy than the average woman in sub-Saharan Africa
did at the beginning, an astonishing finding.
“In India, people are richer, better educated and have fewer
children than those in sub-Saharan Africa, so it’s really surprising that
Indian children are shorter and smaller than those in sub-Saharan Africa,” Ms.
Coffey said in an interview. “But when you step back and look at the state of
Indian mothers, it’s not such a surprise after all.”
Research has shown that genetics play no role in the size
differences, leaving environmental factors as the only explanation, Ms. Coffey
said.
The reasons for Indian mothers’ relatively poor health are many,
including a culture that discriminates against them. Sex differences in
education, employment outside the home, and infant mortality are all greater in
India than in Africa.
“In India, young newly married women are at the bottom of
household hierarchies,” Ms. Coffey said. “So at the same time that Indian women
become pregnant, they are often expected to keep quiet, work hard and eat
little.”
Mothers also suffer from the same sewage-borne infections that
so often kill their babies, made endemic by the primitive sanitation in much of
the country, Ms. Coffey said.
“It is likely that infectious disease is responsible for a signification
portion of India’s pre-pregnancy underweight problem,” she said.
Dr. Shella Duggal, Juhi’s doctor at the mobile clinic, said that
almost every pregnant woman she treats in her visits to Delhi’s slums is
severely anemic. Parasites, spread by poor sanitation and dirty water, are a
crucial reason, she said.
“So the first thing we do is deworm them and give them iron
supplements,” Dr. Duggal said. “And then I tell them to eat.”
It is a prescription many of her patients find difficult to
carry out, she said.
“These mothers are the last persons in their families to have
food,” Dr. Duggal said. “First, she feeds the husband and then the kids, and
only then will she eat the leftovers.”
Juhi said she was trying to eat better.
“I would like to have one more
child,” she said, with a mixture of sadness and hope.@ The New York Times
