(The Gist of Kurukshetra) NATIONAL NUTRITION MISSION (POSHAN ABHIYAAN) [SEPTEMBER-2019]

(The Gist of Kurukshetra) NATIONAL NUTRITION MISSION (POSHAN ABHIYAAN)

Nutrition is acknowledged as one of the most cost effective entry points for human development, poverty reduction and economic development.
Poshan Abhiyan launched in 2017-18 is mandated to reduce the level of undernutrition, stunting, anaemia and low-birth weight babies in most backward districts of the country. National Nutrition Mission or Poshan Abhiyan is an apex body to monitor and supervise nutrition related interventions across Ministries, set-up with budget outlay of 9046.17 crore. The Poshan Abhiyan proposes to introduce robust convergent mechanism by mapping of various schemes related to addressing malnutrition.
The initiatives proposed under Poshan Abhiyaan include real-time monitoring of programme implementation, introducing measurement of children's height at Anganwadi centres, incentivizing States for meeting the targets and involving masses through Jan Andolan.

1. District Hospital

2. Primary Health Centre Community health centre

3. Community

The biggest nutrition supplementation programme is Integrated Child Development Services (ICDS). Launched on 2nd October 1975, the ICDS Scheme represents one of the world's largest and most unique programme to improve the nutritional and health status of children aged 0 to 6 years and pregnant and nursing women.
The programme provides a package of services, comprising supplementary nutrition,
immunisation, health check-up, referral services to children below six years of age and expectant and nursing mothers. Non-formal pre-school education is imparted to children in the age group 3-6 years and health and nutrition education to women in the age group 15-45 years.

ICDS Scheme offers a package of six services, viz. health services are provided in collaboration of NHM usually by ANMs during village health nutrition and sanitation day.
Nutrition component of ICDS aims to provide the following services.
Food supplementation to pre-school children between the age of six months to six years, pregnant and lactating mothers and selected adolescent girls.
Nutrition education to mothers for improving dietary intake and dietary diversity.
Nutrition education regarding appropriate infant and young child feeding.
Growth monitoring and detection of growth faltering.

ICDS is a centrally sponsored scheme implemented by state governments and union territories. Until FY 2005-06, the Government of India (GOI) provided 100 per cent financial assistance for inputs other than supplementary nutrition programme (SNP), which was funded entirely through state budgets. The funding pattern was modified in FY 2009-10. SNP is now funded through a 50:50 ratio except for north-eastern states which have a 90:10ratio. For all other components, GOI provides 90 per cent of the budget.
Many steps have been taken under system strengthening and restructuring of ICDS to improve service delivery :
Public Private Partnership to improve infrastructure and service delivery such as 'NandGhar' project is encouraging and can lead to better dividends.
Decentralized food procurement in few states is a positive step, joint account in the name of AWW and Ward member, Standard menu for the state, community based monitoring, display of standard menu at the AWC, Role of Gram Panchayat in Monitoring and Supervision, involvement of WSHGs for preparing food, etc. help in increasing transparency and accountability.
Improved Management Information System and monitoring and supervision using information communication technology will support quality improvement. Use of ICT and system strengthening efforts in selected states has reported to have helped in improving delivery of services.

School feeding programmes are considered as long term social protection investment that have multiple benefits. They serve three important perspectives: social equity through reaching the most vulnerable children, educational advancement by contributing to learning by increasing children's access to education and maintaining their nutritional status and overall health. Additionally, they provide income support to families through the provision of food to children. Mid day meal perhaps facilitate school performance among underprivileged children and class inequalities.
Mid-day meal programme was launched in 1995 as central sponsored scheme. Under this programme cooked mid-day meals were to be introduced in all government and government aided primary schools within two years. The programme envisaged the provision of cooked meals/ processed food of calorific value as per prescribed norms for children studying in classes IV in all Government, local body and Government aided primary schools free of cost.

The Central and State Governments work hand in hand to implement the programme. Central Government issues guidelines to be followed by State Governments while executing the scheme, some states have developed separate guidelines as well.
Budgetary Allocations Mid- Day Meal Scheme allocation adopted a bottom up approach and is based on Annual Work Plan and Budget (AWP&B), submitted by States/UT Administrations.
State/UT required to ensure that the plans have been prepared at the School level through participatory planning processes as per guidelines (2006). The budget allocation for MDM covered following heads,
Food grain at the rate of 100 gram per child for primary school and 150 gram per child for upper primary schools.
Cooking cost for eligible schools / implementing agencies for meeting the cost of pulses, vegetables, oil / fats, salt and condiments and fuel.
To cover the impact of price rise in the items of consumption in the MDM basket, the cooking cost has been revised upward annually since 2010 @7.5 per cent.
The present cooking cost is Rs. 4.13 per child per day for primary stage and Rs. 6.18 per child per day for upper primary stage (2016).

The above described initiatives highlight the commitment of the Government to address hunger and malnutrition in India.
Although, to achieve nutrition goals, there is a need to address the challenges of bridging the gaps in their implementation, bringing parity and improving the coverage of services.