India needs to scale up direct nutrition interventions

Source: The post is based on an article “India needs to scale up direct nutrition interventions” published in the “The Hindu” on 5^th July 2022.

Syllabus: GS2 – Social Sector; Health Sector; Poverty and Hunger;

Relevance: Hunger and Nutrition; POSHAN 2.0

News: India’s is going to celebrate 75^th Anniversary of Independence, therefore, it is important to see India’s achievements on various fronts as well as areas where India has not performed well.

India’s Achievements

About Prime Minister’s Overarching Scheme for Holistic Nutrition, or POSHAN Abhiyaan 2.0 (or National Nutrition Mission (NNM)

It aims to reduce malnutrition in women, children and adolescent girls. The MOWCD is the nodal Ministry to implement. It aligns with different ministries to work in tandem for the first 1,000 days in life.

It emphasizes on selected high impact essential nutrition interventions, combined with nutrition-sensitive interventions, which indirectly impact mother, infant and young child nutrition.

Key Indicators

As per the NFHS-5 2019-21, India has substantially improved in various indicators of women’s empowerment as compared to the NFHS-4 2015-16. The substantial improvements are:
(1) Antenatal service attendance (58.6 to 70.0%);

(2) women having their own saving bank accounts (63.0 to78.6%);

(3) women owning mobile phones that they themselves use (45.9 % to 54.0%);

(4) women married before 18 years of age (26.8 % to 23.3 %);

(5) women with 10 or more years of schooling (35.7% to 41.0%), and

(6) access to clean fuel for cooking (43.8 % to 68.6%).

Key areas still that still to be addressed even after seven decades of Independence (As per NFHS-5)

(1) There are gaps in direct nutrition interventions, like preconception nutrition, maternal nutrition, and appropriate infant and child feeding between NFHS4 and 5. For example,

(i) Child undernutrition remains high in the first three months. India has 20% to 30% undernutrition even in the first six months of life.

(ii) There has only been a marginal improvement in the practice of exclusive breastfeeding (EBF). This has been despite the fact that there is a policy on infant and young child feeding, and also, there is a ban on sale of commercial milk for infant feeding.

(2) There are gaps in other nutrition intervention, like, complementary feeding practices, i.e., complementing semi-solid feeding with continuation of breast milk from six months onwards. This has been due to lack of awareness to start feeding at six to eight months etc.

What are the implications of poor nutrition?

It adversely impacts health, survival and diminishes the learning capacity, and leads to poor school performance.

In adulthood, it means reduced earnings and increased risks of chronic diseases such as diabetes, hypertension, and obesity.

Way Forward

The government should create awareness at the right time with the right tools and techniques. For example, special care should be given in the first 1,000 days.

The POSHAN 2.0 should be given a push like was done to Swachh Bharat Abhiyaan (SBA). For example, PM can use his ‘Mann Ki Baat’ programme to focus on the scheme.

The POSHAN 2.0 implementation agency should be overhauled to remove any flaws in its implementation.

The government should revisit the Integrated Child Development Scheme (ICDS) which is the nodal system for nutrition programme.

The supplementary nutrition supplied under ICDS can be alternatively supplied through the PDS as Take- Home Ration packets. Further, the ICDS anganwadi workers can be freed to undertake timely counselling on appropriate maternal and child feeding practices.

The government should combine the human resource of ICDS and health sector from village to the district and State levels to delivery of services in the first 1000 days of life.

The government should create awareness on EBF. A well-planned breastfeeding counselling should be given to pregnant women during antenatal check-up prior to delivery. The government should promote the technique of appropriate holding, latching and manually emptying the breast for the optimal transfer of breast milk to a baby.