Why Are Indian Kids Smaller Than African kids? Hint: It’s Not Race

By Sanjay Wijesekera

5 month old Manish, at a Nutrition Rehabilitation Centre, Guna, Madhya Pradesh. In 2013 when this picture was taken, Madhya Pradesh alone had 5% of all open defecators in the world, and 50% of children under 3 were stunted.

A story on the high incidence of malnutrition among children in India reminded us of a curious phenomenon that for years had puzzled development and health professionals. Despite India’s growing economic power and successive governments who paid serious attention to increasing food supply, children in that country remained smaller than those in less well-off countries in sub-Saharan Africa.

It took years of research and large-scale case studies - some of which were published by UNICEF, USAID and WHO in Improving Nutrition Outcomes with Better Water, Sanitation and Hygiene - to pin it down. There is a very widespread lack of adequate and diverse food intake among young children, which needs to be addressed, in both India and poor countries in sub-Saharan Africa. However, in India there is an additional and unexpected villain in the piece: a lack of toilets.

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