[Answered]What do you understand by the term ‘anthropometric failures’? Discuss why despite various efforts, India continues to suffer from some form of anthropometric failures.

Anthropometric failures means failure in front of anthropometric indicators like weight, height etc. indicating malnutrition and undernutrition and is reflected as underweight, stunting and wasting. The recent National Family Health Survey (NFHS 2015–16) confirms that every second child in India continues to suffer from some form of anthropometric failure (either stunting, or underweight, or wasting). Despite considerable efforts, India is yet to witness meaningful reductions in the burden of child undernutrition.

Various reasons for anthropometric failures in India:

1. Lack of Data: Lack of credible data on a year-year basis is a big hurdle to tackle malnutrition and policy formulation. For example, there has been a 10-year gap between NFHS 3 and NFHS 4. Further, there is confusion and inability to understand measurement procedures among ill-trained Anganwadi workers.
2. Corruption: Due to ineffective functioning (corruption and leakages) of the public distribution system (PDS), access to food is a major problem. Loss of food grains in warehouses (due to rotting and theft) further aggravates the problem.
3. Issues with policy implementation: Major issues with schemes like Mid-day meal are the supply of quality food and its uniform distribution. Further, policy implementation on ground level is poor due to lack of funds, gross mismanagement and corruption.
4. Cereal-based Diet: A major reason for micronutrient deficiency in India is because of a cereal-based diet. Even the National Food Security Act does not address the issue of nutritional deficiency adequately. Further, efforts regarding food fortification have also been inadequate.
5. Social-economic and Cultural challenges: Major challenges in implementing nutritional programmes are socio-cultural factors such as caste. Illiteracy among women and gender biases is also a challenge.
6. Financial Constraints: Budgetary allocations of many schemes have decreased over time. Further, the money allocated has remained unspent in many states.
7. Lack of nutritional and health awareness:Lack of awareness, ignorance of healthy diets, unhealthy feeding habits, poor breastfeeding practice are major challenges in reducing malnutrition.

 Various government efforts:

1. Integrated Child Development Services (ICDS) Scheme: The scheme provides specific interventions targeted towards the vulnerable groups including children below 6 years and women.
2. National Health Mission (NHM): National Health Mission (NHM) was launched by the government of India in 2013. It subsumed the National Rural Health Mission and the National Urban Health Mission to enhance nutrition status in India.
3. Mid Day Meal Scheme: It provides that every child within the age group of six to fourteen years studying in classes I to VIII who enrols and attends the school shall be provided with a hot cooked meal, free of charge every day except on school holidays.
4. Indira Gandhi Matritva Sahyog Yojna (IGMSY): The scheme aims to contribute to a better enabling environment by providing cash incentives for improved health and nutrition to pregnant and lactating mothers.
5. National Nutrition Mission (POSHAN Abhiyaan): It seeks to ensure a malnutrition free India by 2022. It is India’s flagship program, which envisages improving nutritional outcomes for children, adolescents, pregnant women and lactating mothers.

 Way forward: 

1. Early life interventions: To address the problem of child under-nutrition, and disease there should be early life interventions targeting the first 1,000 days of a child’s life.
2. Public-Private partnership: Public-Private partnership should be encouraged in schemes like mid-day meal. This would ensure less leakages, and other constraints like delay in supply of food etc.
3. Food fortification: It is important to extend the food fortification of staples. Public-private partnerships can help leverage the appropriate technology for scaling up food fortification interventions. Further, the focus should be on incorporating nutritious food and diversifying the diet.
4. Policy efforts: Agricultural policy should be aligned with nutrition policy with incentives provided for encouraging the production of nutrient-rich and local crops for self-consumption.
5. Effective data: It is important to have sufficient information and reliable, updated data for effective interventions. It is thus necessary to collect and maintain real-time data on various nutrition indicators.

The POSHAN Abhiyan aims to reduce child stunting, underweight, low birthweight and anaemia. To translate such intent into action calls for insightful deliberations on a range of policy issues. The aspirational districts programme is an attempt in the right direction to accelerate progress in poor performing districts.