Malnutrition in India: An overview

Context

India is facing a serious challenge of malnutrition. Many children have reportedly died due to malnutrition. Ending Malnutrition is on the agenda of Sustainable Development Goals.

What is malnutrition?

Malnutrition refers to deficiencies, excesses or imbalances in a person’s intake of energy and/or nutrients.

Malnutrition indicates that children are either too short for their age or too thin. Children whose height is below the average for their age are considered to be stunted.

Status of Malnutrition in India

As per the National Family Health Survey (NFHS)-4 (2015-16)

• 7 per cent children below five years are underweight.
• 4 per cent are stunted and 21 per cent are wasted in the country.
• About 8% of children are stunted
• About 21% of children under the age of five are wasted according to the National Family Health Survey-4 data.
• In the State of Madhya Pradesh 42.8 per cent children below five years are underweight, 42 per cent are stunted and 25.8 per cent are wasted

According to UNICEF,

• India is at the 10th spot among countries with the highest number of underweight children,
• India is on the 17th spot for the highest number of stunted children in the world

Facts from National Family Health Survey 4 data for 2015-16

Of the mothers who participated in the survey, more than 50% provided immunization to their children, across all categories based on caste and education.

Nutritional status varied across categories.

Stunted growth was seen in children of around 51% of the uneducated women compared with 31% of educated women’s children. About 47% of the uneducated women had underweight children.

Percentage of children who were underweight and had stunted growth was greater among Scheduled Tribes compared with other caste categories. Children of around 44% of the women from Scheduled Tribes showed stunted growth and about 45% were underweight.

Initiatives taken by government to reduce Malnutrition

The Government has accorded high priority to the issue of malnutrition in the country and is implementing several schemes and programme:

Direct Targeted interventions:

1) Integrated Child Development Services (ICDS)

2) National Health Mission (NHM)

3) Mid-Day Meal Scheme

4) Rajiv Gandhi Schemes for Empowerment of Adolescent Girls (RGSEAG) or SABLA,

5) Indira Gandhi Matritva Sahyog Yojana (IGMSY)

Indirect Multi-sectoral interventions:

1) Targeted Public Distribution System (TPDS)

2) National Horticulture Mission

3) National Food Security Mission

4) Swachh Bharat Abhiyan

Other steps include:

• National Nutrition Strategy (NNS) has been published by NITI Aayog in 2017 with Vision 2022: “Kuposhan Mukt Bharat”.
• Promotion of appropriate infant and young child feeding practices that include early initiation of breastfeeding,
• Exclusive breastfeeding till 6 months of age and appropriate complementary feeding after 6 months of age.
• Central governments have initiated various programs like MAA (Mothers Absolute Affection) to promote exclusive breast feeding; PradhanMantriSurakshitMatritvaAbhiyan;
• National Iron plus Initiative (NIPI) for Anemia control among children from 6 to 60 months of age.
• Village Health and Nutrition Days and Mother and Child Protection Card are the joint initiative of the Ministries of Health & Family welfare and the Ministry of Woman and Child for addressing the nutrition concerns in children, pregnant women and lactating mothers.
• Specific program to prevent and combat micronutrient deficiencies of Vitamin A and Iron & Folic Acid (IFA) in under-five children, children of 5 to 10 years of age, and adolescents.
• Management of malnutrition and common neonatal and childhood illnesses at community and facility level by training service providers in IMNCI (Integrated Management of Neonatal and Childhood Illnesses) training.
• Rashtriya Bal Swasthya Karyakram (RBSK) provides child health screening for common health conditions by expanding the reach of mobile health teams at block level and establishment of District Early Intervention Centres (DEICs) at the districts for early interventions services. Under the Rashtriya Bal Swasthya Karyakram (RBSK), systematic efforts are undertaken to detect nutrition deficiency among children and adolescents respectively.

Malnutrition is high despite all the efforts due to:

1) Corruption in implementation of schemes

2) Diversion of ration meant for mid day meal

3) Poor quality of food given in mid day meals.

4) Poor sanitation and hygiene decreases the nutrition absorption rate

6) Low social status of women

7) Lack of infrastructure in rural areas.

Way Forward

• A decentralized approach should be promoted with greater flexibility and decision making at the state, district and local levels.
• The ownership of Panchayati Raj and urban local bodies is to be strengthened over nutrition initiatives.
• Mothers should be made aware of the right nutrition their child will need to stay strong and healthy.
• Medical solutions to the problem of malnutrition include de-worming and nutritional supplements. De-worming campaigns are quite effective and have been conducted in many daycare centre and health encampments.
• Overall sanitation and hygiene of rural and urban areas is to be increased. Poor sanitation and frequent illness reduces the child’s nutritional absorption capacity.
• The whole mid day meal process should be made more transparent to make sure that the government initiatives bring out intended results.