[Answered]What are the objective and salient features of National Nutrition Mission? Discuss various challenges to National Nutrition Mission and how to tackle the same.

Malnutrition is the predominant risk factor for death in children younger than 5 in every state of India in 2018, accounting for 68.2% of the total under-5 deaths due to malnutrition. It was also the leading risk factor of loss of health among all age groups. According to the findings, if the trends estimated for the indicators in the Poshan Abhiyaan or National Nutrition Mission 2022 continue in India, there would be 8.9% excess prevalence for low birthweight relative to the 2022 targets.

Objectives of National Nutrition Mission (Poshan Abhiyaan):

1. Improving nutrition: National Nutrition Mission is aimed at improving the nutritional status of Children from 0-6 years, Adolescent Girls, Pregnant Women and Lactating Mothers in a time bound manner during the next three years beginning 2017-18.
2. Convergence: The Abhiyan aims to achieve convergence with various programmes i.e., Anganwadi Services, Pradhan Mantri Matru Vandana Yojana, Janani Suraksha Yojana, National Health Mission, Swachh-Bharat Mission, Public Distribution System, Mahatma Gandhi National Rural Employment Guarantee Scheme.
3. Reducing malnutrition: It focuses on reducing stunting, under-nutrition and anaemia in women and adolescents through direct cash transfers is a massive step towards eradicating malnutrition.

Salient features of National Nutrition Mission:

1. Target to reduce malnutrition: The mission, has a target to reduce under-nutrition and low birth-weight by 2% each year. It will strive to achieve reduction in stunting from 38.4% as per the National Family Health Survey-4 to 25% by 2022. NNM targets to reduce stunting, under-nutrition, anemia (among young children, women and adolescent girls) and reduce low birth weight by 2%, 2%, 3% and 2% per annum respectively.
2. Anaemia targets: It also aims to bring down anaemia among young children, women and adolescent girls by 3% per year.
3. An apex body: The mission will form an apex body that would fix targets and monitor, supervise and guide nutrition-related interventions across the ministries.
4. Use of technology: The mission would include several components like an ICT (information and communications technology)-based real-time monitoring system, incentivising of states and Union territories to meet their targets, social audits, and setting up of nutrition resource centres.
5. Anganwadi workers: Anganwadi workers will also be offered incentives for using IT-based tools such as smartphones. Aadhaar card is a mandatory requirement to avail the benefits of the mission,
6. Monitoring and Convergence Action Plan: Implementation strategy would be based on intense monitoring and Convergence Action Plan right upto the grass root level.
7. Behavioural Change: The scheme proposes to ensure service delivery by the use of more technology, behavioural change through incentives and lists down specific targets to be achieved in a phased manner, thus eradicating malnutrition from the country.

Challenges:

1. Implementation: The intent of the policy is clear, but the implementation could be a challenge. Malnutrition is a complex and multi-dimensional issue and thus need holistic approach.
2. Lack of coordination: Various ministries and departments related to healthcare often operate in isolation.
3. Under-utilisation of funds: The scheme also suffers from under-utilisation of allocated funds (only 16% of allocated resources for 2018-19), just like many other government programmes.
4. Lack of data) Lack of real-time data monitoring, sustainability and accountability may impact the National Nutrition Mission (NNM), Thus there is a need to strengthen monitoring and delivery systems.
5. Human Resources: NNM requires a huge human resource input. In a low-and-middle-income-country with challenges around power supply, literacy, handling technology sensitively and sensibly may require a long period of hand-holding and capacity building.

Way forward:

1. Focus on mothers: The first and the most important step for reducing malnutrition in India is providing sufficient nutrition to pregnant and lactating mothers. The child then automatically is at much less risk of being malnourished.
2. Sate action: States need to extending a wide range of essential services and facilities, from healthcare and clean water to social security and basic infrastructure.
3. Data Collection: Data should be collected comprehensively. Motivating people to report and collect data ethically also have to be emphasised.

The vision to ensure attainment of malnutrition free India by 2022 continues through more innovations and pilot programs and has reached the grass root level households. Poshan Abhiyaan has received global recognition for its effort in eradicating malnutrition. Yet there is far to go in ending malnutrition issue in India.