Healthcare and Nutrition for Women in Assam Was Already Inadequate. Then Came COVID-19

The pandemic is likely to affect an estimated 67 lakh people with myriad vulnerabilities and contribute to worsening of household wellbeing with a spillover effect on nutritional deficiency.

It goes without saying that the COVID-19 pandemic has caused inconceivable human suffering and will worsen gender-based inequalities.

As economic activity grinds to a standstill, women, who were already disadvantaged when it came to accessing decent work, will suffer the most.

In Assam, the unemployment rate is likely to increase and settle in the range between 14% and 25% from the current level of 8% and poverty ratio is expected to rise to 50.8% for the state in the worst possible scenario with a 15% fall in income. The figure is estimated to be 54% for rural Assam.

Estimates from the National Flood Commission of the Ministry of Water Resources show that 31.60 lakh hectares of area are vulnerable to floods in Assam which amounts to 9.4% of the total flood-prone area in the country and affects one-third of the population in the state. The reproductive healthcare and nutritional security of women and children are therefore severely challenged with the additional burden of a possible escalation in poverty in the wake of the outbreak of the coronavirus and impeding flood during monsoons.

The National Family Health Survey (NFHS-4) shows that approximately 36% of women in Assam had a Body mass index (BMI) that was below normal and 8% were obese. Anaemia was prevalent in 72% of pregnant women and 69% of women who were not pregnant. In addition, teenage pregnancy (15-19 years age group) was at 61.4% and 13.6% of them were already mothers.

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The low BMI and anaemic conditions amongst women in Assam contribute towards reinforcing ‘structural deficiency’ in child health. There are 36% children in the state with stunted growth (NFHS-4). Furthermore, adequate breastfeeding and supplementary diet for children has decreased to 49% in 2015 (NFHS-4) compared to 60.1% in 20015 (NFHS-3) in the state.

Only 8.9% of children during the first two years of their lives received an adequate diet. It is therefore not difficult to understand why the incidence of infant mortality rate (IMR) and nutritional deficiency continues to be high in Assam. The low nutritional intake during the first two years of early childhood is also likely to lead to cognitive impairments and further impact growth and development.

Tribal women are seen sowing rice crops in an agricultural field in the outskirt of Nagaon Town in Assam. Credit: Flickr/Diganta Talukdar

Tribal women are seen sowing rice crops in an agricultural field in the outskirt of Nagaon Town in Assam. Photo: Flickr/Diganta Talukdar

Women’s diet is an important indicator of a child’s health. The NFHS-4 data shows that the protein content of diet in Assam is around 7% in rural and 10% in urban areas. The per capita per diem intake of protein in rural Assam is 54.4 gm and for urban areas is 58.8 gm. The average calorie intake per capita per diem in rural Assam is 2120 and 2176 in urban areas and the urban calorie intake per capita is above the recommended calorie intake for poverty level (2100 calorie per day per person) in India but for rural areas, it is below the poverty level (2400 calorie per day per person).

The NSSO’s 66th round data indicates that 59% rural and 52% of urban households in Assam face a calorie deficit (<2700 calorie intake per consumer unit per day).

As per the PLFS 2017-18 data, the unemployment rate for females is 13.6% and 7.2% for males in the state. The labour force participation rate (LFPR) for females is 12.7 and the same for males is 80.3% which means a higher proportion of females stay away from active economic work in the state.

The worker population ratio (WPR) is 10.8% for females and 74.1% for males. The average wage for a male worker is Rs 17,375.5 and for a female worker is Rs 12, 891.9 with a male-female wage differential of Rs 4,484. These add to women’s household vulnerabilities with access to nutritional sufficiency.

Also read: In Assam, the Healthcare Apparatus for Women Needs a Complete Overhaul

Household vulnerabilities are compounded further given that 75% of the total workers in the state are either self-employed or comprises of casual workers and of the 25% in regular employment, 49% are non-regular.

Therefore access to income and work uncertainty for households is acute during the current pandemic. With a halt to economic activities, poverty and deprivation will escalate. The AHDR, 2014 showed that over the past one and a half-decade, the state lost about one-third of the potential aggregate human development due to the prevailing inequalities underlying achievements in education, health and income dimensions. The loss due to inequality was highest in income dimension (44%) followed by health (32%) and education (9%).

The COVID-19 pandemic is likely to affect an estimated 67 lakh people’s livelihood with myriad vulnerabilities and contribute to worsening of household wellbeing with a spillover effect on nutritional deficiency. This is likely to worsen the RCH which may contribute towards reversing the current improvement in MMR and IMR. These will have far reaching consequence on overall human development in the state in years to come. The road map to revamp state economy in fighting Covid-19 cannot ignore this aspect.

Dr Saswati Choudhury is senior faculty at Omeo Kumar Das Institute of Social Change and Development in Guwahati.