(GIST OF YOJANA) Nutritional Status in India [MAY-2018]

(GIST OF YOJANA) Nutritional Status in India

[MAY-2018]

Nutritional Status in India

Although India has made sizeable economic and social gains over the last two decades, the challenge of maternal and child under-nutrition remains a national public health concern and a policy priority for the current government. India is home to over 40 million stunted and 17 million wasted children (under-five years). Despite a marked trend of improvement in a variety of anthropometric measures of nutrition over the last 10 years, child under-nutrition rates persist as among the highest in the world. This inequality is accentuated by stark disparities across states. Future improvements. In nutritional status of Indian children and mothers will require significant investments into human resources with critical health investments at the local levels.

Key Nutrition Metrics

Malnutrition indicators in India “remain among the highest in the world, despite a declining trend since the early 1990s. The recent figures from NFHS 4 are more encouraging showing further improvements on most indicators. Key Centrally Sponsored Schemes (CSSs) with a focus on health have seen budgetary cuts over the last two years, with central allocations to the ICDS has declined almost 10 per cent from Rs. 15,502 crore (in FY 2015-16) to Rs.14,000 crore (in FY 2016-17). AWCs require investment in vital infrastructure (close to half of AWCs do not have functional adult weight scales), and Anganwadi Workers (AWWs) require monitoring to ensure that they are encouraging target groups to avail supplementary nutrition. A complimentary public intervention is the provision of school meals as part of the Mid Day Meal programme. Field studies highlight the link between the provision of school meals and improved cognition. Furthermore, the provision of school meals has been found to lead to improved learning outcomes for children.

Existing Policy Framework

The most prominent government nutrition interventions include the ICDS programme led by the Ministry of Women and Child Development (MWCD), and the NHRM led by the Ministry of Health and Family Welfare (MHFW). Both CSSs prioritise the role of community level organizations AWCs and AWWs under the ICDS and Accredited Social Health Activists (ASHAs) under the NHRM-for the delivery of nutrition interventions to the target groups of pregnant and lactating mothers, and infants.
The NNM will comprise mapping of various Schemes contributing towards addressing malnutrition, including a very robust convergence mechanism, ICT based Real Time Monitoring system, incentivizing States/UTs for meeting the targets, incentivizing Anganwadi Workers (AWWs) for using IT-based tools, eliminating registers used by AWWS, introducing measurement of height of children at the Anganwadi Centres (AWCs), Social Audits, setting-up Nutrition Resource Centres, involving masses through Jan Andolan for their participation on nutrition through various activities, among others. It will be a central nodal agency that helps coordinate central and state government programmes and infuse them with additional funds/resources.

Policy Recommendations

In response to the persistence of the under nutrition challenge in India, and taking note of the evidence evaluation current policy approaches, key lessons for nutrition-specific policy interventions are as follow:

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Strengthen and restructure ICDS, and leverage PDS

ICDS needs to be in mission mode, with a sanction of adequate financial resources (from the central government) and decision-making authority. Last-mile delivery of ICDS interventions needs to standardise the nutritional component of supplementary food, prioritise educational outreach to pregnant and lactating mothers, improve programme targeting, and streamline operations of AWCs through better infrastructure provision and training for AWWs.

Extend coverage of food fortification of staples

Currently, fortification of staples is limited to the mandatory iodisation of salt. However, the Food Safety and Standards Authority of India (F SSAI) is in the process of formulating draft standards for the fortification of food grains which will add to the nutrient value. Additional proposals under consideration include making the double fortification of salt (with iodine and iron), and the fortification of edible oils mandatory. The standards of the hot cooked meal should also be changed to using only fortified inputs. This would help in providing sufficient calories and micronutrients to a large number of children under-live.

Target multiple contributing factors, for example, WASH

The underlying drivers for India’s ‘hidden hunger’ challenges are complex and go beyond direct nutritional inputs . The significant push by the present government since 2014 on sanitation under the Swachh Bharat Abhiyan has increased access to toilets throughout the country. However, the push for toilet construction must be combined with, strategy for behavioural change.
Align agriculture policy with national nutritional objectives Agriculture policy must be brought in tune with nutrition policy, with incentives provided for encouraging.

Boost private sector engagement in nutrition interventions

Private sector collaboration in the form of public-private partnerships (PPPs) has the potential to leverage the appropriate technology for scaling-up food fortification interventions and to develop and distribute nutrient-rich foods to improve maternal and infant nutrition. The government should facilitate PPPs in the sector that can leverage technological solutions for scaling up food fortification initiatives and complement the government’s outreach efforts through mass awareness.

Conclusion

A healthy population is a precondition for sustainable development, and India faces significant challenges in harnessing long-term dividends from its young population. The success of the government’s numerous programmes is dependent on the availability of a trained workforce. India has the world’s highest number of children at risk of poor development: as of 2010, 52 per cent of the country’s 121 million children (under-five) were at risk. Given the ever-increasing weight of the country’s economic ambitions, prioritizing nutrition in an integrated health agenda and realigning nutrition policy to target the first 1,000 days of a child’s life are crucial first steps towards ensuring India’s development rests on steady shoulders.

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