Highlights
The urgency to address poor nutrition in India, especially among children, adolescent girls and women is compelling, and re-confirmed in virtually every survey — from National Family Health survey(NFHS)-4 in 2015-16 to the Global Nutrition Report 2016 and the Global Hunger Index (GHI) 2017, which ranks India at 100 out of 119 countries, with a low overall score of 31.4.
Statistics
- Among children less than 5 years, wasting (low weight for height), continues to be 21% in the 2017 index — it was 20% in 1992.
- There has been a reduction in stunting (height for age) – from 61.9% in 1992 to 38.4% in 2017, reported in the GHI 2017.
- Mortality among children less than 5 years old has declined to around 5% from 11% during the same period, according to both the GHI and the NFHS.
- However, 25% of India’s children less than 5 years old are still malnourished.
- Add to this the fact that 190.7 million people in India sleep hungry every night, and over half of adolescent girls and women are anaemic, and the conclusion is obvious — despite a 7% compound annual growth rate over the last decade and the various programmes to improve nutrition, levels of under-nutrition are unacceptably high.
Schemes and Programmes
- The recently announced flagship program of the Ministry of Women and Child Development will be anchored through the National Nutrition Mission (NNM), or Poshan Abhiyaan, with its own specific budget of Rs.9,046 crore and a proposed World Bank loan of $200 million, to ensure convergence among the various programmes of the government.
- Additionally, NITI Aayog has worked on a National Nutrition Strategy (NNS), isolated the 100 most backward districts for stunting and prioritised those for interventions.
- A cynical view would be that we have seen such declarations before – after all, the special attention to nutrition was highlighted in 2008 when the Prime Minister’s National Council on India’s Nutrition Challenges was constituted.
- A detailed report, “Addressing India’s Nutrition Challenges”, was submitted in 2010 by the Planning Commission, the convergence of an extensive and multi-sector consultation. But nothing changed significantly.
- The optimistic view says that exploring new models to address the structural and systemic issues on a priority basis, learning from what has worked or not, and single-minded focus on implementation will be critical to delivering better nutritional outcomes and meeting the Sustainable Development Goals, to which India is a signatory.
- Additionally, initiatives like Swachh Bharat Abhiyan, where implemented, will contribute positively to nutrition outcomes, and well-structured public-private partnerships could be the catalyst.
- Seen in this context, the overhaul of capacity and capability in three existing programmes, designed to reach populations most at risk, should be the first priority — namely, the Integrated Child Development Services (ICDS), with its network of 1.4 million Anganwadi Centres, reaching almost 100 million beneficiaries who include pregnant and nursing mothers and children up to 6 years; mid-day meals (MDM) that reach almost 120 million children in schools; and the Public Distribution System (PDS) that reaches over 800 million people under the National Food Security Act.
- The National Nutrition Strategy (NNS) has set very ambitious targets for 2022 and the Poshan Abhiyaan has also specified three-year targets to reduce stunting, under-nutrition and low birth weight by 2% each year, and to reduce anaemia by 3% each year.
For purposeful action, it is imperative to have common goals and metrics for improving nutrition, which can then be disaggregated by year, State, district, etc., into a nutrition dashboard, with metrics that are clear and measurable and a real-time tracking mechanism, much like we track economic data.
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